Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Experiment Request Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What facility would you like to use?
*
Nuclear Reactor
Co-60 Irradiator
Electron Linac
Proton Cyclotron
If using the reactor which facility are you interested in?
Neutron Imaging
Rabbit (best for Neutron Activation Analysis)
Beam Port
Through Tube
Other:
Clear selection
Approximately how long do you anticipate your experiment taking?
1 day or less
2-3 days
1 week
More than 1 week
Clear selection
What is the name of your organization?
*
Your answer
What best describes your organization?
*
University of Maryland
Other University
Private Industry
Government
Other:
Please briefly describe your experiment.
*
Your answer
Are you interested in other services?
Neutron Activation Analysis
Gamma Ray Spectroscopy
Dosimetry
Isotope Production
Clear selection
Please provide your contact information so we can get in touch with you.
*
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of University of Maryland, College Park.
Report Abuse
Forms
