Prototyping Lab - Authorized User Request Form


Complete this form to request to become an authorized user of the QI Prototyping Facility. If approved, you will get automatic access to the Design and Assembly Space (room 1202). However, this does not give you access to use any of the machines. For all other rooms and machine access, use the separate form for Machine and Specialized Room Access.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    Must be at least 10 characters.
    This is a required question

    Additional signed forms

    As part of your application to become an authorized user of the QI Prototyping Facility, you also need to complete and sign some additional forms. These need to be scanned and email to us (for our contact information: prototyping.ucsd.edu/contact.php) * USER AGREEMENT: http://prototyping.ucsd.edu/docs/user_agreement.pdf * WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT: http://prototyping.ucsd.edu/docs/waiver_of_liability.pdf * Certificate showing successful completion of UCSD Injury and Illness Prevention Program: http://blink.ucsd.edu/safety/occupational/hazard/IIPP/training.html * AFTER HOUR WAIVER FOR UNDERGRADUATE STUDENTS (only required for undergrads requesting 24/7 or Extended Business Hours access): http://prototyping.ucsd.edu/docs/after_hour_waiver.pdf 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 Prototyping Lab facilities before having received explicit approval from us.