Genes, Development And Behavior
Department of Translational Neuroscience
Utrecht, The Netherlands

Application form

 

Project application form for iPSC Training Facility

Personal details

First name:

 

Family name:

 

Position:

 

Institute:

 

Lab group:

 

Telephone number:

 

Postal address:

 

Zip code & City:

 

Email address:

 

 

Please provide a brief response to the following questions

Project details

Project title:

 

Project description (max. 250 words):

Aim:

 

Motivation for using iPS cells:

 

Assay(s) for which iPS cells will be used:

 

End-point readout:

 

Project duration:

 

Number of cell lines for reprogramming:

 

Number of cell lines:

 

Reason for using this number of cell lines:

 

Type of neuronal differentiation:

Which type of differentiation:

 

Is training required:  Yes/No

Number of employees that will work in the iPSC Facility:

 

Work experience of the employee(s):

Months/years experience with tissue culture:

 

Please attach curriculum vitae of the employee(s)

 

 

 

After completing this document please send it, including CVs, to Sandra Kling.

 

 

Contact information:

Dr. Sandra Kling

IPSC Facility Manager

E: s.kappmeyer@umcutrecht.nl

T: +31 (0) 88 7567334

 

Postal  address:

BCRM iPSC  Training Facility

UMC Utrecht

Str. 4.205

P.O. Box 85060

3508 AB Utrecht

The Netherlands

 

Visiting address:

BCRM iPSC Training Facility

UMC Utrecht

Room Str. 4.233

Universiteitsweg 100

3584 CG Utrecht

The Netherlands