Equipment Request Form

The Mobile Tracking Lab is a new shared research facility that provides a suite of highly portable, mobile data collection tools to be used to collect a rich variety of human activity data in unconstrained physical environments.

---

Personal Information:

Name:
E-Mail:
P.I.:
Phone:
Department:

---

Which MTL instruments do you use?
ASL Mobile Eye Tetherless Eye-tracking Optics ( of 2 sets requested)
Analysis Computer
Training
Accessories:
      Cables Batteries Battery Charger Carrying Pack Manual

When do you want them?

Start Date:
End Date:

---

In the space below, please write a brief description of your research project and your planned usage of MTL equipment.


Are there any special safety considerations involved with you project?   Yes     No     If so, then please describe here:

Do you have Northwestern University IRB approval for this project?   Yes     No

---