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Contact and Biographical Information:
Telephone # (mobile preferred):
Name of P.I. (full name of P.I.):
Lab Affiliation (Dept./Institution):
Applicant's position in the lab
(e.g., lab head, postdoc, graduate student):
Screen Number (if none, please enter "non-screening user"):
1. Detailed description of work to be performed. If this is not part of an ICCB-Longwood screen, please describe the overall project.
(e.g., I need to maintain Vero cell cultures, fill 384-well plates with cell suspension, transfect cells with siRNAs, infect cells with virus-like particles derived from vesicular stomatitis virus, and fix cells for automated microscopy readout. This work is part of an effort to identify and characterize host genes involved in virus infection.)
2. Have you already submitted (or do you plan to submit) a screening application?
3. Please list all screening room equipment needed.
(e.g. Combi liquid dispenser, EnVision plate reader, ImageXpress Micro automated microscope, etc.)
4. What biological materials do you need to bring into the screening room (e.g., cell lines, bacteria, viruses, yeast, purified protein or nucleic acid, cell lysate)? Please provide specific strain/reagent names and sources; omission of this information may delay approval of your request.
(e.g., Vero cells (Cercopithecus aethiops epithelial kidney cells, ATCC CCL-81); vesicular stomatitis virus particles pseudotyped with Ebola virus glycoprotein and carrying a GFP reporter gene (generated in our lab); recombinant Y. pestis transcriptional regulatory protein BacX, purified from E. coli expression strain.)
5. What other reagents do you need to bring into the screening room (including but not limited to buffer components, dyes, fixatives, acids, bases, culture medium, antibodies, etc.)?
(e.g., DMEM cell culture medium, 0.05% trypsin, PBS, paraformaldehyde)
6. Please provide the title and registration number for the protocol approved by your institutional biosafety committee for the materials and work described above. Omission of this information will delay approval of your request.
(For Harvard investigators, this should be your COMS registration title and number.)
7. Predicted approximate duration and frequency of work in the screening room.
(e.g., Up to 2 hours per day, once a week for 3 months.)
A copy of your completed application will be sent automatically to the email address that you provided above.
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