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Registration Form for Mass General Brigham Members

Username and Password

* Required field
*Choose Your UserName:  (5-12 characters)
*Choose Your Password:  (6-16 characters case-sensitive, no spaces)
*Re-type Your Password:

General Information

*First Name:
*Last Name:
*Phone Number:
*Email Address:
*Primary Institution:
*Primary Department:
Email address of Primary P.I.:  (If you don't know your PI's email Address just   enter dnacoreweb@molbio.mgh.harvard.edu )
You may optionally provide your address as well.

Fund Information

You may enter up to five funds.  Each fund is associated with a Business Unit Number. For example, the Business Unit number for MGH is 1200, for Brigham & Women's it's 2200.
The first fund you enter will be your default fund. You may change your default fund, as well as add funds to or remove funds from, your list at any time.
Business Unit: Fund Number:
(default)

Address

You may provide your address if you want. You can always add or edit it after you have registered. It is recommended to provide your address if you ever plan to have materials shipped to you at any location other than:
  • MGH Main Campus, Simches Bldg, Mol Bio Dept., 7th floor
  • MGH Main Campus, Jackson Bldg, 13th floor
  • MGH Charlestown Navy Yard, 6th floor
  • Mass General Brigham Research Building, 1st floor (65 Landsdowne St., Cambridge)
  • MGH CCIB DNA Core, Laboratory Automation Unit
Address, line 1:
Address, line 2:
City:
State or Province:
Country:
ZIP: