Path BioResource

Path BioResource

PROJECT MANAGEMENT
PI-Principal Investigator Lab Manager BA-Business Administrator Staff-Resource laboratories Staff-Path BioResource Reset password

External PI Registration Form

This registration is to be used by PathBioResource clients or their business administrators who will be financially responsible for services provided. By submitting this form, the named Principal Investigator authorizes PathBioResource to verify the information provided and to create a billing account and PennKey login account.

Do not use this form if you are affiliated with the University of Pennsylvania or its Health System, Children's Hospital of Philadelphia, Wistar Institute, Monell Chemical Senses Center, or Philadelphia VA Hospital. Please visit http://www.med.upenn.edu/bmcrc/request_howto.shtml to register as a local client.

External client registration is usually completed within one week, after which your PennKey account setup code will be sent by express mail to the shipping address you provided. You will also receive an email confirming your account is ready with instructions for ordering services. Thank you for registering at PathBioResource.

Receiving a PennKey can take between 7 to 10 business days
Principal Investigator
First Name		Last Name
Phone		Fax
email
shipping address
Institution/Company		Dept.
Line 1		Line 2
City		State/Province
ZIP/Postal Code		Country
Facility you plan to use

Business Administrator (billing contact)
First Name		Last Name
Phone		Fax
email
billing address
Institution/Company		Dept.
Line 1		Line 2
City		State/Province
ZIP/Postal Code		Country
		Organization
Is a Purchase Order required for payment?
May the invoice be sent by email (PDF) instead of a hard copy?
May the invoice be sent by fax instead of a hard copy?

Payment Method

Choose one - your invoice will include payment instructions for these options:

Institutional check for PathBioResource invoice
Bank wire transfer
Credit card (Microarray Facility only) - MasterCard, VISA, AmEx, Discover

A Purchase Order is requested for all services (except credit card orders);
Contact your Resource Laboratory Director if a PO cannot be issued.
FAX your Purchase Order to 215-898-4227, c/o Luellen Fletcher, or mail to

PathBioResource
Luellen Fletcher
John Morgan Bldg #M163
3620 Hamilton Walk
Philadelphia, PA 19104

You may provide your Purchase Order number here, or later when you log in to your account:

PennKey Confidentiality Agreement:

As an individual whose position requires interaction with any or all of the University's administrative information systems, I may be provided with direct access to confidential and valuable data and/or use of data systems. In the interest of maintaining the integrity of these systems and of ensuring the security and proper use of University resources, I will maintain the confidentiality of my password for all systems to which I have access. I will maintain in strictest confidence the data to which I have access.

Confidential information will not be shared in any manner with others who are unauthorized to view such data. I will use my access to the University's systems for the sole purpose of conducting official business of the University. I understand that the use of these systems and their data for personal purposes is prohibited. I understand that any abuse of access to the University's systems and their data, any illegal copying of software, and any misuse of the University's equipment may result in disciplinary action, loss of access to the University's systems, and possible sanctions consistent with the University Policy on Adherence to University Policy.

By submitting my registration I accept the PennKey Confidentiality Agreement.

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