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 ~

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:*
Billing Information
Please 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 06340-6097
Billing Address of Institution/Company:*
Contact Person for Billing Purposes:*
Contact Person Telephone Number:*
*
- I have read and agree to the Cancellation Policy
Email
This field is for validation purposes and should be left unchanged.