Name/address/title/e-mail of corresponding curator at the Göteborg natural history museum Name/address/title/e-mail of applicant Name/address/title/e-mail av project leader Name/e-mail of co-applicant Name/address of institution Date Application form for tissue sampling

Project title

Organism group

Number of desired samples

Type of analysis

Desired amount/volume of material

Time plan/schedule for the project

Name of other institution involved in the project (if applicable)

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Göteborg natural history museum requirements for allowance to take samples:

The samples are only allowed to be used for the purpose stated in the application, for any other use a new application is required

Access of results from sampling as soon as possible

Resulting publication sent to the museum (att. curator) in print or pdf

One copy (data file) of any photo taken of the material

The corresponding curator is informed if any irregularities in the collection is observed, such as for example misidentification or pest attacks

Project description

Date

Signature by applicant	Signature by curator

__________________________	_____________________________

Name in block letters	Name in block letters

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