2023 Algal Applicants

2023 ALGAL CULTURING COURSE

Application Form
Name

First NameLast Name
E-mail
Mobile Number

Area CodePhone Number
Phone Number

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Work Number

Area CodePhone Number
Gender (needed for housing assignments). Please click here for more information regarding our dormitory.
Affiliation
Affiliation Address

Street Address

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Please check the course(s) you would like to attend

Algal Culturing Techniques Course from April 16-22, 2023 (inclusive of travel days)Microalgal Mass Culturing Techniques Course from April 22-26, 2023 (inclusive of travel days)
Briefly describe your present position and duties
Why are you applying for the course and how will you benefit professionally from attending?
Do you have any special requirements that we need to know about if you are accepted to the course (e.g. allergies to latex gloves, food allergies or special requirements)?
Strains of Interest?Do you have a particular strain you are interested in working with? Please let us know and we will do our best to work it into the course.
Please let us know if there is someone at Bigelow you are interested in meeting in person. The research teams are listed on Bigelow’s website at: www.bigelow.org

Media Release

I enter into this Media Release Agreement with Bigelow Laboratory for Ocean Sciences (Bigelow Laboratory). I authorize Bigelow Laboratory to create recordings of my image, likeness and/or voice (collectively, “Recordings”) in connection with the National Center for Marine Algae and Microbiota (NCMA) Algal Culture Techniques workshops at Bigelow Laboratory. I agree the Recordings may take form of photographs, films, video and audio tapes, CD-ROMs, DVDs, digital files and/or other media of any form now known or later developed. Bigelow Laboratory, at its discretion, may use and allow others to use the Recordings in their original or edited form in any media for any and all educational commercial purposes, and may use and allow others to use my name, image, likeness, voice and biographical, or other information in connection with the Recordings. I understand that use of the Recording may include, but not necessarily be limited to, the following:Internal use at Bigelow Laboratory and the NCMAStreaming in digital format (live or on –demand) on the InternetI further acknowledge that I will not be compensated for any uses made of the Recordings and that Bigelow Laboratory will exclusively own all rights to these Recordings; however, except for the permissions I am granting here, I retain the right I may otherwise hold in copyrighted materials incorporated into the Recordings. I hereby release Bigelow Laboratory from all Claims relating to the use of the Recordings. For this purpose, a “Claim” is any legal proceeding, such as a suit for defamation, invasion of privacy for infringement of copyright. In addition, my release of Bigelow Laboratory includes Bigelow Laboratory itself, as well as Bigelow Laboratory’s officials, employees, representatives, agents, licensees, successors and assigns. I have read and understood the contents of this Release Agreement and I have the right and authority to execute it.
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Emergency Contact Information
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Medical Insurance Plan name
Medical Insurance Subscriber Name
Medical Insurance Plan Number
It is agreed and understood not to hold Bigelow Laboratory for Ocean Sciences responsible for any injury occurring to me while I am attending the Algal Culturing Course from April 30 May 9th - 15th, 2020, run by the Provasoli-Guillard National Center for Marine Algae and Microbiota (NCMA), Bigelow Laboratory for Ocean Sciences. In case of accident or serious injury, I hereby authorize Bigelow Laboratory for Ocean Sciences to make whatever arrangements necessary to secure emergency medical care.
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2023 ALGAL CULTURING COURSE

Media Release

Emergency Contact Information