NSLS Faculty-Student Research Support Program

Application Form

TO QUALIFY YOU MUST BE FROM A U.S. INSTITUTION OF HIGHER EDUCATION.

REQUESTS/QUERIES should be directed to the Information and Outreach Office, National Synchrotron Light Source, Building 725B, P.O. Box 5000, Brookhaven National Laboratory, Upton, NY 11973-5000, (631) 344-5132, or via e-mail at NSLSinfo@bnl.gov.

This application is being submitted for the January - April, 2009 beamtime cycle.

1. Participants

Faculty Member Information:
First Name
Last Name
Title at Institution
Phone Number
E-mail Address
Institution
Department
Street Address 1
Street Address 2
City
State
Zip Code

Student / Postdoc Information:
#1 First Name
#1 Last Name
#1 Position

#2 First Name
#2 Last Name
#2 Position

2. Type of Participation at the NSLS

Requests for support must be made for each scheduling cycle in which your research team will be conducting experiments at the NSLS (e.g., January-April, May-August and September-December).

COMPLETE (a) and SELECT EITHER (b) or (c).

a. Research team will be conducting experiments on beamline for days.

A General User Proposal was submitted. Reimbursement commitments will be made commensurate with beam time allocation.

Scheduling Cycle: January - April 2009

PASS Form Number (Proposal Number):

PRT collaboration or feasibility/exploratory visit.

Collaborator or Beamline Contact Person:

3. Eligibility

To qualify, the faculty applicant must be a new user to the NSLS and/or a new faculty member at their institution.

a. Are you currently a badged user at the NSLS? If yes, please enter your guest number.

Yes
No

Guest Number:

b. Are you a new faculty member (Assistant Professor or equivalent) at your institution?
If yes, when did your faculty appointment begin?

Yes
No

Month: Year:

4. Type of Funding Requested

Please give estimates for items below for which you are requesting funding. Please note: Housing and per diem requests cannot exceed beamtime allocation indicated in item 2a.

ORIGINAL RECEIPTS ARE REQUIRED FOR REIMBURSEMENT.

	Travel¹	Housing²	Per Diem³	Car Rental⁴
Faculty	$	$	$	$
Student #1	$	$	$
Student #2	$	$	$

¹Please note, total reimbursable expenses for travel cannot exceed the coach airline fare. ²Housing will be reimbursed at the BNL on-site dormitory rate. ³Per diem will be reimbursed at the current BNL rate. ⁴One economy car rental per research team is an allowable expense.

For Travel funding requests, please explain mode of transportation to NSLS.

5. New Applications Only

In a few paragraphs, please describe the purpose of the proposed visit and/or the experiment(s) proposed. If any member of the research team has experience working at synchrotron radiation facilities, please note their name, the synchrotron facility at which they worked, and the number of years experience. Please be aware that this section provides primary input to the Application Review Committee.

6. Renewal Applications

Please describe your successes/failures from the past beamtime and plans/goals for this beamtime.

By clicking on Submit below, you are certifying that the funds requested are required for the proposed visit to the NSLS, and no alternate sources of funds are available to me for this purpose.