Lunar and meteorite samples loan scheme application form

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* 1. Your details

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Co-official's details

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. What is the purpose of the loan?

If you are borrowing the samples on behalf of a university, please confirm that you will only be using the samples with university aged students.

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* 4. Date the samples are required (normally Monday - Friday inclusive)

First choice

Date

Second choice

Date

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* 5. How did you hear about the scheme?

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* 6. Have you borrowed the moon rocks before at this location?

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* 7. Have you been the official or co-official of a previous lunar and meteorite loan at this location?

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* 8. Please provide details of the security measures you have in place for protecting the samples upon arrival at your institution

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* 9. What type of safe or secure storage do you propose to use?

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* 10. Where is the safe or secure storage located?

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* 11. Who holds the keys or has the combination for the above?

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* 12. What are the security arrangements for the building in which the samples will be stored?

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* 13. What are the security arrangements for the building at weekends (if applicable)?

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* 14. How do you propose to ensure the security of the samples while they are in use?

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* 15. Please estimate how many people will see the samples

500

1000

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 16. Data Protection

The personal information you supply in this form will be managed by STFC (who are part of UK Research and Innovation) in accordance with the provisions of the General Data Protection Regulation (GDPR) and Freedom of Information.

We will not use your information for any other purpose, other than in relation to the scheme. More information about data privacy is available on the UKRI website.

Would you like STFC to issue a press release about the samples to your local media and send a copy to you?

Lunar and meteorite samples loan scheme application form

Question Title

* 1. Your details

Question Title

* 2. Co-official's details

Question Title

* 3. What is the purpose of the loan?If you are borrowing the samples on behalf of a university, please confirm that you will only be using the samples with university aged students.

Question Title

* 4. Date the samples are required (normally Monday - Friday inclusive)

Question Title

* 5. How did you hear about the scheme?

Question Title

* 6. Have you borrowed the moon rocks before at this location?

Question Title

* 7. Have you been the official or co-official of a previous lunar and meteorite loan at this location?

Question Title

* 8. Please provide details of the security measures you have in place for protecting the samples upon arrival at your institution

Question Title

* 9. What type of safe or secure storage do you propose to use?

Question Title

* 10. Where is the safe or secure storage located?

Question Title

* 11. Who holds the keys or has the combination for the above?

Question Title

* 12. What are the security arrangements for the building in which the samples will be stored?

Question Title

* 13. What are the security arrangements for the building at weekends (if applicable)?

Question Title

* 14. How do you propose to ensure the security of the samples while they are in use?

Question Title

* 15. Please estimate how many people will see the samples

Question Title

* 3. What is the purpose of the loan?

If you are borrowing the samples on behalf of a university, please confirm that you will only be using the samples with university aged students.