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:
Argonne National Laboratory
APS User Office, 401/B1100
9700 S. Cass Ave.
Argonne, IL 60439

Fax: 630-252-9250

Need Assistance: contact Jacki Flood, 630-252-7566 or send inquiry to [email protected]
Note: fields marked with * are required.

Institution Information

Institution Name

Which category best describes your institution?

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

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

Which user facility will be hosting you?

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

Name

Position Title

Address 1

Address 2

City

State

Zip Code

Country

Phone

Fax

E-mail Address

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

Contact Name

Contact Phone

Contact E-mail Address

User Agreement Details

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

09.24.2019

To comment on the contents, please contact [email protected] or 630-252-9090.