Invasive/Destructive Analyses Request

Invasive/Destructive Analyses Request

Applicant Details

Name*

First NameLast Name

Organization

Title

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address*

example@example.com

Phone Number

Please enter a valid phone number.

If student, course details and name of supervisor with contact details

Institution carrying out analysis, with contact details

Supporting Funds

Project Information

Project Title

Names and affiliations of collaborators

Brief description of research aims

How will The Children's Museum of Indianapolis collections contribute to your research aims?

In what format will the research be disseminated?

Please provide references to any published work relating to your project's aims or techniques

Please provide the name and contact details of a scientific referee for your project

Object Information and Technical Details

For each object or sample requested, please provide the following information:

Accession Number(s)

Method of sampling

Who will do sampling and previous experience

Can sampling be done in the museum

YesNo

Date required

Date

Method of storing sample after analysis

Method of analysis (including non-destructive, eg. radiography)

How will the sample or object be affected during analysis?

If permission for sampling and analysis is granted, I agree to undertake the following:

To provide a copy of any thesis or publication (or relevant part thereof) arising from my analysis to The Children’s Museum of Indianapolis, within 6 months of submission or publication date; and
To return samples to The Children’s Museum of Indianapolis within 6 the allocated loan period.

(Failure to meet these conditions will prejudice future requests from researchers and their institutions).