CCRC Analytical Services Request Form

Prior to completing this form, we recommend that you contact AST Technical Director Parastoo Azadi at azadi@ccrc.uga.edu.

CCRC Analytical Service Request Form
Client Name
Client Name
First
Last
PI/Manager Name
PI/Manager Name
First
Last
Institution/Organization Type
Mailing Address
Mailing Address
Street address line 1
Street address line 2
City
State/Province
Zip/Postal
Major Source of Non-CCRC Funding
Sample Type
Sample Source
Intellectual Property

For analytical and characterization services conducted at the CCRC:

  • Data generated for a completed service request is the property of the client, regardless of institutional or industry affiliation.
  • Methods development completed by the CCRC for the completion of a service request is the property of the University of Georgia.

Fees

Fees for each project will be determined by Dr. Azadi upon discussion with investigators and will be tailored to each project depending on complexity and depth of data needed.

Intended Payment Method
Publication of Non-Proprietary Data

**For medically related projects, use the following statement:

This research was supported through the NIH-funded National Glycoscience Resource, CCRC Service and Training (NIH grant no. R24GM137782) to Parastoo Azadi at the Complex Carbohydrate Research Center.

**For non-medical projects, use the following statement:

This work was supported by the U.S. Department of Energy, Office of Science, Basic Energy Sciences, grant number DE-SC0015662 to Parastoo Azadi at the Complex Carbohydrate Research Center.

By typing your name above, you are signing this electronically. You agree that to the best of your knowledge the information you have filled in on this form is truthful and accurate. You agree that you have signatory authority for your company/organization and that your electronic signature is the legal equivalent of your written signature.