User Registration Form for the Advanced Photon Source (APS) and the Center for Nanoscale Materials (CNM)

This registration form is intended for users who will conduct hands-on work, utilize resources remotely, mail in samples for analysis, or collaborate on a proposal at the APS and/or CNM facilities.
Answer all questions - an incomplete form can delay approval for access to Argonne.
    Non-US citizens:
  • DO NOT begin until you have your immigration and naturalization documents available that establishes both your identity and legal immigration status (e.g., passport, visa, EAD card, I-20, DS-2019, I-797, or other supplemental documentation).
  • Remote and mail-in access from outside of the United States does not require an active visa.
  • The Department of Energy requires current and complete CVs/resumes with your registration form. Click here for CV requirements and information.
Required: Select your user facility (can choose one or both).
Advanced Photon Source (APS)
Center for Nanoscale Materials (CNM)
JUSTIFICATION FOR REQUEST  
  Supply enough information about the purpose of proposed visit to justify registration approval. Provide sector number if known and brief summary of the proposed research. If you are currently on a proposal, provide the GUP # for APS or CNM proposal #:
  (You have characters left.)
 
Estimated date of arrival or date of remote access
Field of Research  
Is any of your planned research proprietary or potentially proprietary? Yes  No 
Have you ever been assigned a badge number by Argonne National Laboratory? If so, please provide. Yes  No 

 
badge: 

ORCiD identifiers are required. Click the radio button to register for an ORCiD (if needed) and authorize APS/CNM as Trusted Organization(s). ORCID I authorize APS/CNM as a Trusted Party (e.g. to download publications, upload beam time and service awards, etc.). 

Clear ORCiD
Your ORCID
The APS experiment hall floor is a radiation protection area. All persons must adhere to posted dosimetry requirements. I acknowledge that I must submit a request for a dosimeter at least 72 hours (3 business days) in advance of my arrival at the APS. Yes, I acknowledge.
N/A - I will not require access to the APS experiment hall floor.
Title (Prof., Dr., etc.) 
Legal First/Given Name  
Alias/Preferred Name  
Middle Initial      (if none, check "NMI" for No Middle Initial)   NMI
Legal Last/Family Name 
E-mail Address that we can use to contact you 
Demographics Questions
? By providing your demographic information, you are assisting with the Department of Energy (DOE) Office of Science's continued commitment to broadening access and opportunity in sponsored programs and facilities. Alternatively, for information you wish not to disclose, please select, "Do Not wish to Provide." Your individual demographic information will not be shared and will not be used for any decision-making regarding individual access to the facility. Aggregate, anonymized demographic information will be shared with the DOE Office of Science on a periodic basis, and aggregate, anonymized demographic information may be shared with confidential review committees who are charged to evaluate the facility operations and management.
Gender  Male  Female  Another Gender Not Listed  Do Not Wish to Provide 
Race 
Ethnicity 
Disability 
(Select all that apply) 
Country of Citizenship 
Country of Second Citizenship 
Date of Birth  
Are you currently affiliated with more than one institution? Yes  No 
What Employer/Affiliation is covering your work at Argonne?   
Type of Business  
Department 
Street address 1 
Street address 2 
City 
State/Province 
Zip Code 
Country 
Telephone (999-999-9999) 
Employment Level 
 
If you chose "Other" as your "Employment Level" please provide details here:
Name of the secondary institution that you are associated with:   
Type of Business  
Department 
Street address 1 
Street address 2 
City 
State/Province 
Zip Code 
Country institution is located in 
Employment Level 
 
If you chose "Other" as your "Employment Level" please provide details here:
CURRENT RESIDENCE
Street address 1 
Street address 2 
City 
State/Province 
Zip Code 
Country 
Telephone (999-999-9999) 
Cell Phone Number (999-999-9999)     or I do not have a cell phone
EMERGENCY CONTACT
Name of FAMILY MEMBER to contact in the event of an emergency 
Relationship to user 
Home Address of Emergency Contact 
Phone Number of Emergency Contact (999-999-9999) 
Email Address of Emergency Contact 
NOTIFICATION TO USERS: The U.S. Department of Energy Office of Science (SC), which is the primary sponsor of the APS and CNM, requires that a limited set of information relating to your user project/experiment be transmitted to SC at the conclusion of the current fiscal year. A subset of this information, including your name, institutional affiliation(s), and project titles(s), will be publicly disseminated as part of an SC user facility user projects/experiments database on the SC website, http://science.energy.gov, after the conclusion of the fiscal year. For proprietary projects, SC requests that the user provide a project title that is suitable for public dissemination.

Non-US citizens: DO NOT begin until you have your immigration and naturalization documents available that establishes both your identity and legal immigration status (e.g., passport, visa, EAD card, I-20, DS-2019, I-797, or any other supplemental status documentation required to confirm your identity and legal immigration status). The Department of Energy also requires current and complete CVs/resumes in PDF format to accompany the registration form.

City of Birth
Country of Birth
Educational Background MUST provide each higher-education degree completed (BS, MS, PhD - include years obtained and names of institutions)
 
DegreeName of University or CollegeYear degree conferredAction
Please indicate if you have Baccalaureate Degree or not
 
Please indicate if you have Master Degree or not
 
Please indicate if you have Doctorate Degree or not
 
Please indicate if you have additional degrees
 

Identify which of the following you hold:
Select your legal file type
LPR (legal permanent resident-green card holder)
LPR Number Click here to upload LPR file
LPR Expiration Date
EAD-STEM OPT Number Click here to upload EAD-OPT file
EAD-STEM OPT Expiration Date
EAD Number Click here to upload EAD file
EAD Expiration Date

PASSPORT
Passport Number Click here to upload passport file
Passport Country of Issue
Passport Expiration Date

VISA
Visa Type Click here to upload visa file
Visa Number
(Red number in lower right-hand corner,
starts with a letter)
Visa Expiration Date
Institution Sponsoring the Visa Document

Other required form of identification Click here to upload other file
USCIS Form Number
Expiration Date on USCIS Form
Curriculum Vitae (CV) Information
All CVs must include
  • Include full name at the top of the page. Include your address, e-mail address, and phone number(s).
  • CVs must include all employment activities since the age of 18 years with no unexplained gaps in time over the past 10 years. If there is a gap of 6 months or more, reasoning for gap is required (i.e., layoff, unemployed, extended vacation, starting family, etc.).
  • A description of your research/science interests and technology specialties.
  • CVs must include the current/accurate name of all academic institutions attended and all degrees/diplomas with years earned.
  • All publications (if you have no publications, please indicate).
  • Do not include any Personally Identifiable Information (PII) on your CV (i.e., Date of Birth, City of Birth, etc.)
Click here to upload file  
 
Click button ONCE when finished. By submission of this form, I certify that the information provided herein is true, accurate, and complete.