R/V Connecticut Time Request Form REVISED: August 2001 Note: You must read and agree to the Cancellation Policy before submitting your ship request form. ~ ALL FIELDS REQUIRED, answer NA if not applicable ~ R/V Connecticut Time Request Form Project (Title and Brief Description):*Principle Investigator:* Host Institution/Company:* E-Mail:* Phone:* Other Institutions/Scientists involved:*Total Number in Shipboard Party:* Total Number of Ship Days Funded:* Date, Time and Port of Loading:*Date, Time and Port of Departure:*Area of Operations:*Date, Time and Port of Return/Offloading:*Shipboard Equipment Requirements:*Equipment brought aboard by science party (provide weight/size of large items):*MSTC Supporting Equipment/Techs Needed:*Radioactive/Hazardous Material/Explosives Carried:*Clearances/Licenses/Permits Required:*Are Diving Operations Planned:*YESNOBilling InformationPlease indicate if cruise is funded. If pending please indicate when funding is expected to be secured:* Enter FRS# Or PO#:* Mail Purchase Order, Contract No. or Project No. to: University of Connecticut Marine Sciences & Technology Center Attn: Turner Cabaniss 1080 Shennecossett Road Groton, CT 06340-6097Billing Address of Institution/Company:*Contact Person for Billing Purposes:* Contact Person Telephone Number:* * I have read and agree to the Cancellation Policy NameThis field is for validation purposes and should be left unchanged.