Material Transfer Agreement (MTA) Request: Incoming MTAs

Instructions

  • This is a smart form and must be filled out electronically.
  • Please complete the information and questionnaire below. Optional fields are marked. All other fields are required.
  • Clicking “yes” on some check boxes will display additional mandatory fields to be completed.
  • You can save a copy of the form at any time using the Save button and complete the form at a later time.
  • Submit the form by clicking the Submit button and following the prompts. This will send a copy of the form to Industry Engagement via your normal email. Please note, the submit process will not work until all required fields are filled out.
  • Industry Engagement will confirm receipt and review the form and initiate the agreement review process. Please contact industry@bu.edu if you do not receive a confirmation within three business days).
  • First time here? Learn more about MTAs and how to use this form.

Incoming MTA Form

  • 1. BU PI Information:
  • (Include room, street, and ZIP code.)
  • 2. External Party Information:
  • Please include the title or a brief description of the related research.
  • 5. BU-Owned Spaces:
  • If in BMC-owned space, the MTA should be sent to the BMC Grants Office: https://www.bmc.org/research-operations
  • 6. Research Location:
  • 7. Animal Information:
    If you intend to use the material in humans, we will reach out to you to discuss this MTA further.
  • 9. Human-Derived Material:
  • 10. Biohazard and Biosafety Information:
  • E.g. Biohazardous materials, infectious agents, select agents, human blood, tissues, cells & cell lines, etc.
  • (Check all that apply.)
  • 15. How will you fund the research to be conducted with the Material?
  • 18. Confidential Information
  • Principal Investigator Certification: I certify that the information I have provided about this project is accurate. Furthermore I certify that I will direct this project in compliance with Boston University policies, with the terms and conditions of Boston University's Material Transfer Agreement with the Provider and with all applicable laws and regulations.

  • You may sign this form using S-signature format .e.g. /John Q. Doe/
  • MM slash DD slash YYYY
  • Drop files here or
    Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 100 MB.
    • This field is for validation purposes and should be left unchanged.

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