ScanImage & Ephus User Survey (2011-2012)

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1. Name identifying your lab/entity, e.g. PI's full name

Name identifying your lab/entity, e.g. PI's full name

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2. Contact email address identifying your lab/entity, e.g. shared lab email or email of PI

Contact email address identifying your lab/entity, e.g. shared lab email or email of PI

3. Optionally, provide one additional contact for your lab/entity (e.g. yourself if not the same as the identifying name/email above)

Optionally, provide one additional contact for your lab/entity (e.g. yourself if not the same as the identifying name/email above)   Name:
Email Address:

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4. Primary institution of lab or entity, e.g. university name.
(If lab/entity is independent, use the same name here)

Primary institution of lab or entity, e.g. university name. (If lab/entity is independent, use the same name here)

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5. Primary location of lab/entity

Primary location of lab/entity   US Canada Latin America

UK Europe Asia

Australia Other

6. Detailed primary location of lab/entity

Detailed primary location of lab/entity   City/Town:
State (US Only):
Zip Code (US Only):
Country:

7. Web address for your lab/entity (if available)

Web address for your lab/entity (if available)

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8. Is the work in your lab/entity related to neuroscience, at least in part?

Is the work in your lab/entity related to neuroscience, at least in part?   Yes No

9. Please identify any/all of the following descriptions which apply to your lab/entity:

Please identify any/all of the following descriptions which apply to your lab/entity:   Core Facility (shared by other labs/entities) Receive HHMI funding NOT biomedically oriented (physics, chemistry, engineering, etc)