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Research, Group, and General User Application
UVA Nondiscrimination Policies

Returning users please just give us new or updated information.
We appreciate your patience as we try to upgrade and simplify our forms.


Personal Information:


Name:
First Middle Last (required)
Date of Birth:
Month: Day: Year: 19
4-Digit PIN (required)
(Choose something unique that you will remember and be able to log in with later..)

Current
(e.g.. School) Contact Information:
Address Line 1 Phone
Address Line 2 Email (required)
City State/Province Zip/Postal Code

Optional Permanent or Alternate (eg. Home) Contact Information (if different from above):
Address Line 1 Phone
Address Line 2 Email
City State / Province Zip/Postal Code

Emergency Contact:  
Name Phone


Status For Which You Are Applying
(required): (You may check more than one box if, for example, you are applying to the REU program and to take a course).

Researcher - choose "type" of researcher:
 
Who's lab?
MLBS course instructor
Visiting group leader (e.g. external programs / visiting field trips)
Other (e.g. guest of station resident / childcare provider). Describe:


Planned Arrival Date: Month: Day: Year:
Planned Departure Date: Month: Day: Year:

Housing Request: Apartments and cabins are reserved for faculty, researchers, and families. Course and REU students are usually assigned to undergraduate dorms. Cost varies with accommodation.


Housing requests or concerns (e.g. allergies, disabilities, etc.):

Note: Smoking is not permitted in any Mountain Lake labs or residential buildings.

Sex (for dorm assignments):
Female 
Male
How many will be in your party? Include mates, offspring, other cohabitators, and yourself.

Names and ages of accompanying party: 



Station resident (if not you) responsible for paying your bill?


 
How did you learn about Mountain Lake? Check all that apply.
Brochure, Poster or Display made available through my school.
Brochure sent directly to me.
Web site.
Current or former Mountain Lake student.
Current or former Mountain Lake faculty.
Instructor or Advisor.
On-line database or student opportunities clearing house.


If your have been to Mountain Lake Biological Station before, when? And in what capacity?



For Researchers Only. Others Please Skip this Section.

Research Activity:

Title of Your Research Project.


Name of Your Institution:


Do you have a current NSF grant to support your research at MLBS (inc. Pre-doc and DDIG)?
Yes No


Please paste in a description of the research you wish to conduct. Describe research sites, land use and/or experimental manipulations, and time line of work.
Please also list all sources of support for your research.


Will your work involve non-local organisms? Yes No

Explicit permission from the Director is required before any non-local organisms may be transported to MLBS or the vicinity. This requirement is to safeguard against the potential for ecological or genetic invasions and the spread of disease.

Will your work involve vertebrate animals? Yes No


If "Yes" you must click here here for information and instructions.

All animal users are responsible for knowing and satisfying, all state, federal, and institutional requirements for working with animals. This includes all IACUC and Occupational Health requirements.

Failure to satisfy all UVA and MLBS animal use requirements will result in immediate suspension of work at MLBS.


Please paste in a copy of your CV, including a complete list of publications:


Research Support:
MLBS has some funds to help cover field station costs for graduate students and young faculty. To apply, please include a brief support budget here (e.g. housing, research fees, research expenses). MLBS has some funds to support pre- and postdoctoral research. These scholarships typically range from $350 to $2,000. Review of applications for research support begins March 15. If you wish to be considered for this in-house fellowship please paste in a budget for your support request, and a list of current and pending support.


Please list any special equipment or facilities you will need access to. Also please identify lab space needs. e.g. How many people need to be housed in your lab?:



Review Application and Continue:

  • Review your application for completeness and accuracy before submitting.
  • Make sure any required supplementary material reaches us by the deadline. Copies, faxes and scanned attachments are acceptable.
  • After clicking "Submit" below you may continue on and complete the on-line"Field Station Risk Acknowledgement Application" (a liability waiver). This need not be done now, but it must be done before you arrive at the station. Remember to select the "animal use" option appropriate to your course, research, or activity.
  • All correspondence with applicants will be via email. Contact us if you need to correspond by some other means.
  • Click "Submit" below now, and continue on to the Risk Acknowledgement section if you wish.

ACKNOWLEDGMENTS: Please acknowledge "Mountain Lake Biological Station, University of Virginia" in any publication, report, or electronic communication in which work conducted at Mountain Lake is mentioned.

Last Name, current Email, and 4-digit PIN fields are required for form to submit.

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This site is not an official university document and some information may be out of date or inaccurate. Fees, program dates and details including support specifics, policies, and all other material are subject to change without notice .  On-line forms, applications, communications, or file transfers via this site are not secured or encrypted. We can not be responsible for the security of information transmitted.

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mlbs.org or www.mlbs.virginia.edu - This page last updated:  Monday, 30-Nov-2009 15:28:30 EST