Policy and Safety Acknowledgement Form

For more information about NMR Facility policies and safety or a more detailed explanation of the guidelines and rules, please talk to Dr. Hongjun Zhou before turning in this completed form.


I hereby acknowledge that I have read, understand and agree to observe the policies and safety guidelines posted on the Facility website when working in the UCSB Department of Chemistry and Biochemistry NMR Facility. I also understand that violation of the safety guidelines or Facility policies may result in the termination of my user privileges.

USER FULL NAME (PRINT): _____________________________________

SIGNATURE: _______________________________

DATE: _______________

SUPERVISOR: ______________________________

SIGNATURE: _______________________________

DATE: _______________



FOR OFF-CAMPUS INSTITUTION ONLY:

  • NAME OF INSTITUTION:___________________________________________________