________________________________________________________________________________
Molecular and Cellular Imaging Facility
Advanced Light Microscopy Unit -
Advanced Analysis Centre
University of Guelph
Guelph, Ontario, Canada N1G 2W1
Dr. Michaela Strüder-Kypke
519-824 4120 ext. 52737
https://www.uoguelph.ca/aac/facilities/molecular-and-cellular-imaging
confocal@uoguelph.ca
The Molecular and Cellular Imaging Facility appreciates the acknowledgement of the facility in your
publications. This recognition! is important for receiving continued! support from CFI and! other granting
agencies.
BILLING INFORMATION and TRUST FUND AUTHORIZATION
Client name: ____________________________________________________________________
Email address: __________________________________ UGrad MSc PhD PDF Other
Supervisor: ______________________________________________________________________
Department: ____________________________________________________________________
Phone extension: ___________________ Building, Room #: ___________________________
Project Title: ____________________________________________________________________
Fund Allotment Maximum for Fiscal Year 2017/2018: __________________________________
Yes, please charge the initial membership fee (Sep 2017 Apr 2018) of $ 250.00 to my account
No, I don’t want to pay/have already paid the initial membership fee (Sep 2017 Apr 2018) of $
250.00
Date: ____________________________
Faculty Authorization: _____________________________________________
I hereby authorize the Molecular and Cellular Imaging Facility and CBS Clerical Unit Staff to charge my grant via
journal entry for all costs incurred relating to the use and work completed for me by this facility. I approve
payment for this work within a 10% variance of the fund allotment maximum given below.
I will submit new authorization forms as required to reflect Trust Fund changes or price increases above 10%
variance.
Trust Fund #
6
4
2
5
1
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