Your name EXACTELY as it appears on your Cornell ID card (Last, First) *
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Last 4 digits of Cornell ID card *
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Research Group *
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Billing account for NMR charges
(This MUST be an actual, 7-digit account number that we can use to bill your usage (eg A581234 or E745678). If you don't know it, ask your group members or PI.)
*
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Current Position *
Phone number (Optional, but helpful). Please enter as 6072550709. No spaces, no separators.
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Preferred gender pronouns (Optional)
Special accommodations required (Optional)
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