Shared Lab Usage Agreement

To initiate or renew a Shared Laboratory Usage Agreement with the Boston University Photonics Center, please complete and submit the form below.

First and last name of the person who will sign the shared laboratory usage agreement document.*
First Last
Email address for the person who will sign the shared laboratory usage agreement document.*
Official name of company:*
Corporation location:*
Year of incorporation:*
Official Company Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Point of contact for the agreement to be sent to:*
First Last
Email address for the person to whom the agreement will be sent:*
Point of contact and email address for the person to whom insurance certificate requests should be made:*
First Last
Email address for the person to whom insurance certificate requests should be made:*
Please enter the name, email address, and BU ID Number (U#) of your primary users of the shared labs. If a new member is being added who does not have a U number, please indicate that they are a new user you would like to be set up.*
Point of contact for billing (i.e. invoices will be sent to the attention of this person):*
First Last
Phone Number for billing contact*
Email address for billing contact*
Full Company address to which invoices should be sent:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country