Complete this form if you are a group leader wishing to host an event at the Station, or a researcher wishing to conduct work here. Only one form per project/activity is needed. This form also lets you request research support. Housing reservations are done separately: Visiting groups (e.g. events, conferences, meetings) will be contacted by someone from MLBS to arrange housing and other logistics. Individual Station users must complete a housing request to secure a reservation following approval of this application. All applications will be reviewed as soon as possible. We will contact you approving the work, or asking more questions. Please contact us any time to follow up. Personal Information First Name * Middle Name Last Name * Your Home Institution Contact Information Address Line 1 Address Line 2 City State or Province, and Country Zip or Postal Code Phone * Email * What best describes your current status? * Faculty Postdoc Graduate Student Undergraduate Student Researcher (but none of above) K-12 Educator K-12 Student Professional Staff MLBS Staff Artist Guest of a Resident or Family Member Other... What best describes your current status? Other... Proposed Research or Activity This is an application to: * Conduct research Use the Station for some other purpose, e.g. visiting group or class Title of Project or Activity (will be used in MLBS reports and public information) * Start Date of Overall Project * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2021202220232024202520262027 End Date of Overall Project * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028202920302031203220332034 Date when you hope to first visit MLBS for this project (not a commitment nor a reservation) * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2024202520262027 Expected lab or group size visiting MLBS * 123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100 Description of work * Please complete all sections that apply to your work, and tell us anything else we should know. 1. Goals: 2. General procedures: 3. Potential short-term or long-term impacts to the land or biota of MLBS or surrounding area: 4. Potential conflicts with other work at the Station: 5. Planned manipulations of organisms or environment: 6. Collections of any kind (indicate species and approximate numbers/amounts): Identify facilities, equipment, or space you request us to provide * GPS Coordinates of Research Area (if Known) Will your work involve non-local organisms? * No Yes Will your work involve vertebrate animals? * No Yes Use of vertebrates requires special advanced approval. Please see: Use of Vertebrate Animals in Research and Teaching. All animal users and handlers are responsible for knowing and satisfying all state, federal, and institutional requirements. This includes all home institution and University of Virginia IACUC and Occupational Health requirements. List sources of support for your work Is your work supported by the NSF? No Yes, Division and Program... Is your work supported by the NSF? Yes, Division and Program... Research Support Request (optional): MLBS has some funds to help cover costs of doing research for graduate students and early career faculty. If you wish to be considered for one of these awards please provide a brief budget (e.g. station fees and research expenses) and information on any other current or pending support. Review of applications for support begins March 15. Research Support Help Us How did you learn about Mountain Lake? Check all that apply Brochure, Poster or Display made available through my school Brochure sent directly to me Web site Current or former Mountain Lake student Current or former Mountain Lake faculty Instructor or Advisor On-line database or student opportunities clearing house Other... How did you learn about Mountain Lake? Check all that apply Other... Please review your application before submitting. Thank you very much! CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.