Visiting Research Application for a Science Center Visitor

 
Please complete the following form and click on "Submit" at the bottom of this form.

Please Note: Completion of this form is required of all members of the Marine Biological Laboratory visiting research community except for faculty and students in summer courses. This includes Research Award Applicants and all visitors to resident laboratories.
 
Personal Data
 
Family (Last) Name: 
First Name:      Middle Name: 
Gender:  Male   Female
Highest Degree:  MD/PhD    MD    PhD    MS    BS    High School
 
Arrival Date:  (mm/dd/yyyy)
Departure Date:  (mm/dd/yyyy)  Be as accurate as possible
 
Academic Rank
(or equivalent): 		 Professor   Associate Professor   Assistant Professor  
Post-Doc   Graduate Student   Undergraduate Student  
Other  
Citizenship:   (If not U.S. citizen)
 
Home Address and Phone
Street 1:      Street 2: 
City:      State/Province: 
Zip/Postal Code:      Country 
Email: 
Phone:      Fax: 
Cell Phone: 
 
Institution Address and Phone
Institution Name: 
Department: 
Street 1:      Street 2: 
City:      State/Province: 
Zip/Postal Code:      Country 
Email: 
Phone:      Fax: 
 
Best:  Mail: Home Inst.     Email: Home Inst.     Phone: Home Inst.
 
Emergency Contact
Contact Name: 
Contact Phone: 
 
Research Project Title (if applicable): 
 
Which Center/Program will you be visiting? 
 
MBL Hosts: 


 
MBL Housing
 
I have read and accept all housing conditions, fees and policies, including the cancellation policy as published on the MBL Housing Web Page  I accept
 
Did you stay in a cottage last year?  Yes  No    If Yes, where? 
Did you have storage?  Yes  No
 
Select your position at MBL:
Sponsor: 
Arrival Date (2PM checkin):  (mm/dd/yyyy)
Departure Date (10AM checkout):  (mm/dd/yyyy)
  In view of commitments to others, these dates must be adhered to unless other prior arrangements are made with the Housing Office.
 
Housing Accommodations
Housing needed for: Applicant Only   Applicant and Family*   Applicant and Colleague**   Housing Not Needed  
* If housing is needed for family or colleagues, please fill in below.
** All colleagues must be registered and submit their own housing application indicating the dates they will be staying with you. They must also be listed below on this housing application.
First NameLast NameRelationship to ApplicantAge (Children Only)Gender (Children Only)
Do you need a crib?  Yes   No
 
Specific conditions to be taken into consideration when assigning accommodations:


 
Request to bring a pet
Pets are not allowed in any dormitory, apartment or house. However, a limited number of cottages (summer only) have been designated as "pet" cottages. Pets are allowed in those cottages with prior approval by the Housing Office. There is a $250 per pet refundable deposit for those approved to have pets in their cottages. Your application will not be processed until you submit a credit card number to the Housing Office:(508) 289-7431 or housing@mbl.edu. Applicants are limited to two pets. Should pets damage the cottage or disturb neighbors, the occupants may be asked to vacate the premises immediately and may jeopardize future housing privileges. The presence of pets in "non pet" cottages will result in immediate eviction from the premises. Requests will be considered based on availability of pet-approved cottages.
If you would like to bring a pet, please enter: Type of Pet:    Weight:
 
Meal Plans
Required for all guests staying in dormitories during the summer season.
 
A meal plan is available during the summer course season only. All courses are provided with a meal plan. Guests residing in housing without kitchens are required to be on the meal plan. (Cottage and apartment residents are not automatically assigned meal plans.) All other guests are welcome to purchase a meal plan. The MBL provides a meal plan that includes 3 meals a day, Monday - Saturday in the main dining room on the second floor of the Swope Center. There is an option for a Sunday brunch. There is no credit for missed meals.
Are you tax exempt?  Yes   No
If yes, institution name: 
Begin meals on:  (mm/dd/yyyy)   My first meal will be: 
End meals on:  (mm/dd/yyyy)   My last meal will be: 
Sunday brunch option:  Yes   No
When selecting the Sunday brunch option, all Sundays will be booked with the meal.
Meal cards needed for my family:  Yes   No    Please Note: Family meals are not tax exempt.
 
Payment Method
Payment Method:     MBL Account (if applicable): 
 
 
 
 
 
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Woods Hole Massachusetts