Bokningsformulär för lärare/kursledare Application for access at Kristineberg marine research station Apply for space at Kristineberg Marine Research Station – Teachers/Leaders Undergraduate course, PhD student course, workshop and conference at Kristineberg Marine Research Station Information about university and course University * Department * Name of course * Name of course part at Kristineberg * Course level * Basic level Advanced level Not applicable Information about responsible person for part at Kristineberg Given name and family name * Phone E-mail address * Course leader, if not the same as above Number of students * Number of course leaders and assistants * Date of arrival * Estimated time of arrival Date of departure * Estimated time of departure Are experiments on vertebrates or cephalopods included? * Yes (include authorization from the ethical committee on animal experiments) No Do not know, supplemented later Include authorization from the ethical committee on animal experiments * Include authorization from the ethical committee on animal experiments Are work with alien species and/or alien populations included? Yes No Do not know, supplemented later Specify species and/or population * Are work with radioactive substances included? * Yes, special permit is required (specify isotope and activity in MBq) No Do not know, supplemented later Specify isotope and activity in MBq * Are work with other hazardous substances requiring labelling included? * Yes No Do not know, supplemented later Specify substance * Are microbial work and/or work with GMO (genetic modified organisms) included? * Yes No Do not know, supplemented later Please specify * Need for resources Lecture halls/conference rooms Yes No Do not know, supplemented later Specify for the number of persons as well as which days and times you request Specific marine species * Yes No Do not know, supplemented later Please specify marine species * Space and equipment on lab * Yes No Do not know, supplemented later Specify what and for which days * Space in thermoregulated rooms * Yes No Do not know, supplemented later Specify temperatures, if you want to regulate water, air temperature, or both. Specify if you want to use deep, surface water, or both. And how much space you need (m2). * Need of special instruments * Yes No Do not know, supplemented later Please specify2 * Other need for laboratory resources * Yes No Do not know, supplemented later Please specify3 * Does the task require diving? * Yes No Do not know, supplemented later Specify diving competence qualification * Field equipment * Yes No Do not know, supplemented later Specify what equipment and for which days * Need of research vessel Alice * Yes No Do not know, supplemented later Specify number of hours * Need of small boats * Yes No Do not know, supplemented later Specify number of boats and which days and times * Meals * Yes No Do not know, supplemented later Specify any requests for special diets * Specify any other requests of meals, for instance refreshments or special evening menu Accommodation * Yes No Do not know, supplemented later Other special requirements I accept that my name will be visable in the list of visitors in the stations lobby during my visit. Billing information Invoice address, specify any ansvarsställe, beställar-ID or reference * VAT number * Consent for storing submitted data * Yes, I give permission to store and process my data Submit Kontakt Bokning, KristinebergTel: 070-302 11 57E-post: kmf@polar.se
