Prototyping Lab - Machine and Specialized Room Access Form

Complete this form to request access to machines or specialized rooms such as the Machine Shop (MS), the Wet Etch Lab (WEL), or the Laser Cutter Room (LCR). You also need to be an authorized user of the Prototyping Facility, which gives you access to the Design and Assembly Space (DAS).
Full Name *
Your answer
Official email address *
Your answer
Student or employee PID *
(for non-UCSD, please write "external")
Your answer
Home department *
(for non-UCSD, please write your company name or "personal")
Your answer
UCSD status (undergraduate/graduate/ postdoc/scientist/faculty/staff/…) *
(for non-UCSD, please write your company title or "individual")
Your answer
Are you on the QI payroll? *
Charge index *
(index number to charge to; if unavailable, write "unknown")
Your answer
Requested start date *
MM
/
DD
/
YYYY
Requested end date *
MM
/
DD
/
YYYY
Access Hours *
(default is Regular Business Hours; check Definitions tab for more info)
Spaces you request access to
Machines you request access to
Briefly describe why you are requesting access to these rooms/machines. *
(include an explanation of the access hours requested if they are not Regular Business Hours)
Your answer
By submitting this form, you agree to that you will comply with the prototyping lab User Agreement, including the Policies and Procedures and the general and machine specific safety guidelines. However, submission of this form by does not grant you the right to access the facilities or use the machines. You are not allowed to use any machine before having received explicit approval from us.
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