Note: Items with an * must be filled out. (Fill in with N/A if they are not applicable)
*Principal Investigator (PI):
*PI E-mail Address:
Select a beamline.
Port 011 - Undulator Four Meter Normal Incidence Monochromator
BM2 IRENI Beamline
Port 031 - Infrared Beamline
Port 033 - HERMON
Port 041 - Wadsworth
Port 041 - VLS-PGM
Port 042 - 6m Toroidal Grating Monochromator
Port 043 - Mark V Grasshopper
Port 051 - Stainless Steel SEYA
Port 053 - Ames - Montana Combined ERG - Seya
Port 061 - White Light
Port 062 - 6m Toroidal Grating Monochromator
Port 071 - Plane Grating Monochromator Branch A
Port 071 - Plane Grating Monochromator Branch B
Port 081 - Four Meter Normal Incidence Monochromator
Port 091 - Apple PGM
Port 093 - Canadian Double Crystal Monochromator
Port 123 - Ten Meter Toroidal Grating Monochromator
*Experiment Run Dates:
*Other Participating Experimenters (please note new users)
*Email Addresses of All Participating Experimenters
*List of samples and chemicals used or brought for your experiment (You must supply a Material Safety Data Sheet (MSDS) for each chemical used in an experiment. Also, be sure and make usage and storage arrangements with the safety officer) :
*List of equipment that may produce safety hazards (lasers, x-ray sources, high-energy electron guns, etc.):
*Method of handling and disposing of samples and chemicals (use additional sheets and drawings if necessary):
*I verify that all personnel have completed, or will complete the SRC Radiation Safety Course prior to arrival to the SRC. Radiation dosimeters cannot be issued until this course is completed. You only need to complete this course one time.:
*"I have discussed with other participating experimenters the risks and proper methods of handling the hazardous materials and using the hazardous equipment involved in our experiments at SRC."
Please submit this form no later than one month before your scheduled beam time.
Note: Access to the Beamline is contingent on completion of this form.
For more information contact:
*Person Completing Form:
The Synchrotron Radiation Center is primarily funded by the University of Wisconsin-Madison with supplemental support from facility Users and the University of Wisconsin-Milwaukee.
It is operated by the Graduate School of the University of Wisconsin-Madison.
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