KCC Resources
Shared Resource Registration Form


First Name:
Last Name:
Select PI By Name:
PI Name (Lastname, Firstname) :
Is PI a KCC Member?:
PI EMail:
KCC Program:
Enter Desired Username:
Sequencing Web Acct*:
*If you don't know this, leave it blank.
E-Mail Address (must be valid):
Department:
Phone Number:
Building:
Room:
Address1 (Non-TJU Clients):
Address2 (Non-TJU Clients):
Administrator (Default Departmental Administrator):



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