Visiting investigator or guest application

Your information will be submitted to our Director of Research.

*Designates required information

Part I: Personal Information


Sex     
 (MM/DD/YY)
 (MM/YY-MM/YY)

You will need to mail your CV and your Research Proposal (500 word maximum) to:

The Jackson Laboratory
Attn: Annie McDonnell
600 Main St
Bar Harbor, ME 04609

Part II: Housing


The Jackson Laboratory operates six 2-bedroom cottages, known as the Woodlands Cottages, which are available to Visiting Investigators and Guests during June thru September. These cottages, which are located one-quarter mile from the Laboratory, are fully furnished except for linens. A use fee is charged and no pets are permitted. If you wish to be considered for a Cottage, please provide the information requested below.

Check here if you wish to be considered for a Woodlands Cottage.
      How many people will there be in your party?

Part III: Research Facilities

   

Yes

No

Provided
by Sponsor

1.
2.
3.
4.
5. (if Yes, see Part VII)
6. (if Yes, see Part VII)
7. (if Yes, see Part VII)

Facilities Utilization
In order to help us anticipate requirements for research space and facilities, please indicate below the approximate percentage of time during the period of your appointment that you expect to be physically present at the Laboratory (include time at the bench, in consultation, and in the Library.)

Lab/Animal Space
Office Space

Part IV: Animal Use


Much of the research at The Jackson Laboratory is based upon irreplaceable colonies of laboratory animals. Introduction of infectious diseases could have disastrous consequences not only for research at the Laboratory, but also for research programs elsewhere that depend upon our animals. Therefore, we require that all visitors observe the regulations summarized in thedocuments entitled “Visitor Regulations”, “Procedures for Bringing Equipment and Non-biological Research Materials to The Jackson Laboratory”, and “Policy on Importation of Animals & Biological Materials.”

Will your proposed research at The Jackson Laboratory involve the use of animals or animal tissues?
   

Part V: Equipment


Will you bring equipment to The Jackson Laboratory?
     No

If yes, please list equipment and indicate which equipment items of any will come in contact with animals.

  Direct Contact Indirect Contact

Part VI: Personal Health


1. The Jackson Laboratory Employee Health Office will ask Visiting Investigators to complete a health/medical questionnaire if he/she will be at the Laboratory for longer than three (3) months. The reason for this is to be alerted to any potential occupational health risks for the individual. For example, a person that comes to The Jackson Laboratory with a history of allergies and/or asthma may have a potential possibility of exacerbation of allergy symptoms if mouse room work was going to be a part of the work or research to be done. After review of the completed form, the Manager of the Employee Health Office will call for information or clarification or to set up an appointment, if necessary, once the person is on campus.

2. If a Visiting Investigator or Guest requires accommodation for a medical problem or condition, it would be advisable to call the Employee Health Office in advance of arrival to The Jackson Laboratory.

For more information, please call the Manager of Employee Health Office at (207) 288-6096.

Part VII: Safety


Radioisotopes:

Will your proposed research at The Jackson Laboratory involve the use of radioisotopes?
  

Will your proposed research at The Jackson Laboratory involve the use of X-Ray producing equipment?
    


Individuals planning on conducting research involving radioisotopes and/or X-Ray producing equipment will need to complete the Registration and Radiation Badge Request Form.

Will you bring chemicals or drugs to The Jackson Laboratory?
    


Are any of these supplies controlled substances or prescription drugs?
    

If yes, indicate by C (controlled) or P (prescription) drugs in the list above.

Carcinogens/Mutagens/Teratogens:

Will your proposed research at The Jackson Laboratory involve the use of any carcinogens, mutagens, and/or terotogens?
   

Will you bring biological materials, such as, transplantable tumor plasma, ascites fluids, cell cultures, cell-culture products, blood, sera, plasma to The Jackson Laboratory?
    

Name of biological material: Proposed In-Vivo Use In Vitro