生命科学研究基盤センター

Application Form for Use(For External Users)

    ※Required

    1. Authorized User in Charge

    Name

    Organization

    Department

    Address

    E-mail

    Tel

    2. Primary User ※If different from the Authorized User in Charge, please enter the Primary User.

    Name

    Department

    E-mail

    3.Service

    Equipment Usage

    Confocal Laser Scanning Microscope(SP8 FALCON)Confocal Laser Scanning Microscope(LSM980)All-in-one Imaging Platform(Mica)Inverted Fluorescence Microscope(AxioObserver 7)Light-Sheet Fluorescence Microscope(Lightsheet Z.1)Flow Cytometer(Cell Sorter MA900 for animal cells, for plant and microorganism samples)Flow Cytometer(FACSAria Fusion for animal cells only)Single-Cell Analysis Platform(Chromium iX Standard System)

    Technical Service

    Quadrupole-Orbitrap Mass Spectrometer(Orbitrap Exploris240)Ion Trap-Orbitrap Mass Spectrometer(Vanquish Duo UHPLC - LTQ)Next-Generation Sequencing Sample PreparationBioinformatics AnalysisCultivation of experimental plants

    Technical Assistance

    Technical Assistance TrainingGeneral Technical Assistance

    Additional Information for Mass Spectrometry

    Request Details(Please provide a brief description.)

    Number of Samples(If the number is not yet determined, please provide an estimate.)

    Additional Information for Single-Cell Analysis

    Request Details

    Next-Generation Sequencing Sample Preparation:Number of samples submitted(Numbers only)

    Bioinformatics Analysis:Number of analyses(Please enter the number of runs using half-width digits, counting fewer than 12 samples as one run.)

    Additional Information for Plant Experiment Support

    Request Details

    Number of Usage

    Additional Microscope User Information

    Research Project Title

    Usage Category

    1_First-Time User (Training Required)
    If this is your first time using the equipment, you are required to attend an orientation and training session covering the facility rules and basic operation before use. The availability and schedule of the training session will be arranged after prior consultation.
    2_Trained User / Continuing Use
    This category is intended for users who have already completed the equipment training and understand the basic operating procedures. Users are generally expected to perform all procedures independently, including setting measurement conditions, loading samples, acquiring images, and saving data.
    3_Use Requiring Prior Consultation
    Select this option if your use involves special samples, long-term observation, advanced imaging conditions, or requires confirmation regarding acceptance as an external user. The feasibility of the request and the appropriate usage method will be determined on a case-by-case basis after reviewing the details.

    If you selected Option 3, please describe the details of your request.:

    Purpose of Use

    ResearchEducationDevelopmentOther

    Please provide details:

    Period of Use

     ~  ※The date(s) and time(s) of use will be determined after consultation with the facility staff.

    Total Planned Usage Time (hours)

    Information on Samples to Be Brought In

    Whole organismTissueCellsMicroorganismsOther

    Specific Species and/or Cell Line Names:

    Sample Status:FixedUnfixed

    Human-Derived Samples:YesNo

    Details of Sample Status:

    Compliance with Relevant Regulations and Guidelines

    Bioethics / Human Research EthicsAnimal ExperimentsGenetically Modified Organism (GMO) ExperimentsPathogenic Microorganisms / Specified Pathogens (including toxins)Radioisotopes and Radiation-Related RegulationsOther

    Sample Information

    GMO Experiment Classification( )
    GMO Experiment Approval Number(

    The introduction of toxic, hazardous, or pathogenic samples is prohibited. Samples cannot be stored in the facility. Samples must be brought in and either taken back or properly disposed of after each experiment.

    Please read and understand the Shared Microscopy Facility Cleaning Manual. After use, users are required to perform the prescribed cleaning procedures.

    4. Billing Information

    Billing Address

    Billing Organization / Department

    Billing Contact Name

    Billing Contact Email

    Billing Contact Phone

    Implementation Guidelines for the Shared Facility Promotion Program of the Life Science Collaboration Center (LiSCo), Nara Institute of Science and Technology

    Implementation Guidelines for the Shared Facility Promotion Program

    I agree to comply with Implementation Guidelines for the Shared Facility Promotion Program of the Life Science Collaboration Center (LiSCo),
    Nara Institute of Science and Technology.

    ▲ Top