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Argonne User Facility Agreement Questionnaire

Individuals who are not Argonne employees are not permitted to do experimental work at any Argonne User Facilities until a User Agreement (UA) with that individual's home institution is established. Please fill in the requested information so the Argonne UA Specialist can furnish the appropriate User Agreement(s) to your institution for signature.

This form may be printed and returned by fax or mail. Download printable version (PDF)

Address any questions to:

Anne Owens
User Agreement Specialist
Argonne National Laboratory, Bldg. 401
9700 South Cass Ave.
Argonne, IL 60439
Phone: (630) 252-7833
Fax: (630) 252-3222
E-mail: userforms@aps.anl.gov

* indicates required field

Fields marked * are required.

Institution Information:

1. Institution Name *required

as you wish it to appear in the Agreement(s)

 

2. Which category best describes your institution? *required

Please select University or College: Private in U.S. or Foreign University or College: State or County U.S. Government Industry DOE Laboratory Other Research Institute

 

3. If the institution is a DOE lab, what is the DOE Contract Number?

 

4. When will personnel from the above-named institution begin working at Argonne? (If not yet determined, enter "unknown.") *required

 

5. Which user facility will be hosting you? *required

Advanced Leadership Computing Facility (ALCF) Advanced Photon Source (APS) Argonne Tandem Linear Accelerator System (ATLAS) Center for Nanoscale Materials (CNM) Electron Microscopy Center (EMC)

 

To whom should the User Agreement(s) be sent for authorized legal signature (such as Legal Department, Sponsored Research Office, etc.)?

6. Name *required

 

Position Title *required

 

Address 1 *required

 

Address 2

 

City *required

 

State

 

Zip Code *required

 

Country *required

 

Phone *required

 

Fax *required

 

E-mail Address *required

 

Contact information for person completing this questionnaire (if different from above):

7. Contact Name

 

Contact Phone

 

Contact E-mail Address

 

User Agreement Details:

8. What type(s) of experiments will be done at Argonne by employees/students of the above-named institution? *required

Learn the difference between nonproprietary and proprietary

Nonproprietary Proprietary Both Nonproprietary and Proprietary