Department of Biology

First Name:

Last Name:

Current Position:

-- Select -- Faculty Student Visitor Other

Phone:

- Phone (next 3 digits): - Phone (next 4 digits):

Email:

Requested Greenhouse(s):

Merion Science Complex

Start Date:

End Date:

Please list the Names and Positions of any additional participants who will be working on the project. If none, enter none.

Additional Participants:

Please provide a brief rationale for requiring access or use of the requested greenhouse.

Rationale for Access:

Please indicate how much space and how many tables you will need?

Space Requirements:

Please list all of the equipment and materials that you intend to use.

Equipment/Materials:

Please list the specific type(s), numbers, life cycle stages (e.g., seeds, seedlings, vegetative adults, reproductive adults, etc.), and origin (e.g., purchased from plant supplier, collected in the wild, etc.) of all plants that you will be bringing into a greenhouse.

Plant Descriptions:

Please list any special requests that you may have (e.g. east side, floor only, etc.) If none, enter none.

Special Requests:

OPTIONAL: Please provide any additional comments or suggestions.