![](media/image1.jpeg){width="4.0in" height="2.1770833333333335in"}

**User Center Contacts**

Materials Analysis -- Dr. Larry Allard (865-574-4981)
<allardlfjr@ornl.gov>

Diffraction --- Dr. Andrew Payzant (865-574-6538) <payzanta@ornl.gov>

Thermography & Thermophysical Properties -- Dr. Ralph Dinwiddie
(865-574-7599) [**dinwiddier@ornl.gov**](mailto:dinwiddier@ornl.gov)

Residual Stress -- Dr. Camden Hubbard (865-574-4472)
[hubbardcr@ornl.gov](../../../../../../../../htm/UserProposal2005/hubbardcr@ornl.gov)

Mechanical Characterization & Analysis -- Dr. Edgar Lara-Curzio
(865-574-1749)
[laracurzioe@ornl.gov](../../../../../../../../htm/UserProposal2005/laracurzioe@ornl.gov)

Friction, Wear, & Machinability -- Dr. Peter Blau (865-574-5377)
<blaupj@ornl.gov>

\*Sponsored by the U.S. Department of Energy, the Assistant Secretary
for Energy Efficiency & Renewable Energy, Office of FreedomCAR and
Vehicle Technologies.

*Official Use Only*

HTML Research Proposal Form *(Tab key navigates to next field.)*

+----------------+----+-------------------------------+---------------+
| [Type of       |    |                               |               |
| Researc        |    |                               |               |
| h]{.underline} |    |                               |               |
|                |    |                               |               |
| Proprietary    |    |                               |               |
| *(must pay, do |    |                               |               |
| not publish)*  |    |                               |               |
| Nonproprietary |    |                               |               |
+----------------+----+-------------------------------+---------------+
| [Title of      |    |                               |               |
| Proposal       |    |                               |               |
| ]{.underline}: |    |                               |               |
|                |    |                               |               |
|                |    |                               |               |
+----------------+----+-------------------------------+---------------+
| [Name of       |    |                               |               |
| Organization   |    |                               |               |
| Submitting     |    |                               |               |
| Proposa        |    |                               |               |
| l]{.underline} |    |                               |               |
|                |    |                               |               |
|                |    |                               |               |
+----------------+----+-------------------------------+---------------+
| [Name of HTML  |    |                               |               |
| Research Staff |    |                               |               |
| with Whom You  |    |                               |               |
| Have Discussed |    |                               |               |
| Pro]{.un       |    |                               |               |
| derline}posal: |    |                               |               |
|                |    |                               |               |
|                |    |                               |               |
+----------------+----+-------------------------------+---------------+
| [Spokesperson  |    |                               |               |
| who will be    |    |                               |               |
| the primary    |    |                               |               |
| contact for    |    |                               |               |
| this           |    |                               |               |
| projec         |    |                               |               |
| t]{.underline} |    |                               |               |
|                |    |                               |               |
| *(Cannot be a  |    |                               |               |
| student):*     |    |                               |               |
+----------------+----+-------------------------------+---------------+
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| width: 30%" /> |    |                               |               |
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| class="odd">   |    |                               |               |
| <td><p><em>P   |    |                               |               |
| refix</em></p> |    |                               |               |
| <              |    |                               |               |
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| <t             |    |                               |               |
| d><p><em>First |    |                               |               |
| Name</em></p>  |    |                               |               |
| <p>            |    |                               |               |
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| <td            |    |                               |               |
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| Name</em></p>  |    |                               |               |
| <p>            |    |                               |               |
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| <              |    |                               |               |
| td><p><em>Last |    |                               |               |
| Name</em></p>  |    |                               |               |
| <p>            |    |                               |               |
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| </tr>          |    |                               |               |
| </tbody>       |    |                               |               |
| </table>       |    |                               |               |
+----------------+----+-------------------------------+---------------+
| *Address Line  |    |                               |               |
| 1*             |    |                               |               |
+----------------+----+-------------------------------+---------------+
| **     **      |    |                               |               |
+----------------+----+-------------------------------+---------------+
| *Address Line  |    |                               |               |
| 2*             |    |                               |               |
+----------------+----+-------------------------------+---------------+
|                |    |                               |               |
+----------------+----+-------------------------------+---------------+
| *City*         | *  | *Zip*                         | *E-mail*      |
|                | St |                               |               |
|                | at |                               |               |
|                | e* |                               |               |
|                |    |                               |               |
|                |    |                               |               |
+----------------+----+-------------------------------+---------------+
| *Phone Number* | *F |                               |               |
|                | ax |                               |               |
|                | N  |                               |               |
|                | um |                               |               |
|                | be |                               |               |
|                | r* |                               |               |
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+----------------+----+-------------------------------+---------------+
| How did you    |    |                               |               |
| hear about the |    |                               |               |
| HTML?          |    |                               |               |
|                |    |                               |               |
| **     **      |    |                               |               |
+----------------+----+-------------------------------+---------------+

+-----------------------------------------------------------------------+
| Contact Information for Each User Who Will Perform                    |
|                                                                       |
| Hands-on Research at HTML (limit 4):                                  |
+-----------------------------------------------------------------------+
| User 1: Spokesperson Yes, spokesperson will be visiting No, not       |
| visiting                                                              |
+-----------------------------------------------------------------------+
| First Name Middle Name Last Name Email                                |
+-----------------------------------------------------------------------+
| User 2: **     **                                                     |
+-----------------------------------------------------------------------+
| User 3: **     **                                                     |
+-----------------------------------------------------------------------+
| User 4: **     **                                                     |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+

Proposed Research

In paragraph form, summarize your proposed research project below,
answering each question. Please be sure to address each point.

1\. Background:

## Describe the larger R&D effort to which this proposal belongs.

> **     **

## B. Which aspect will be affected by the outcome of your research at HTML (e.g. solving a production problem, testing of a fundamental theory, or developing a new product)? {#b.-which-aspect-will-be-affected-by-the-outcome-of-your-research-at-html-e.g.-solving-a-production-problem-testing-of-a-fundamental-theory-or-developing-a-new-product .unnumbered}

> **     **

C. Relationship to the Department of Energy's transportation
technologies, if any. See <http://www.eere.energy.gov/vehiclesandfuels/>

> **     **

D. If successful, what would be the economic impact (e.g. energy
savings, implications for improved processes or products, money saved,
jobs created or saved, implications for improved energy efficiency).

> **     **

2\. Funding:

## Please indicate the funding agency that is sponsoring this research 

> DOE, DOD, NASA, NSF, Homeland Security
>
> Other (specify      )

## Title of sponsored project (if applicable)

**     **

C. If a university is the submitter of project, please provide name of
industrial organization funding your project (if applicable).

**     **

3\. Problem:

What problem are you trying to solve? Why?

**     **

4\. Experimental Approach: (Detailed test matrix requested in Q. 13).
Reason for

selecting each instrument and desired information you hope to obtain
from

use of each selected instrument.

     

5\. Dates Requested: (List three possible dates to visit HTML,
m/d/yyyy.) HTML requires that users analyze data at the HTML in
collaboration with HTML staff. Please allow time for this analysis.

Date 1: **     ** Date 2: **     ** Date 3: **     **

Specify dates you cannot come.

**     **

> When do you need this information? **     **

6\. Literature References:

> List up to five of the most pertinent references from your literature
> study about this research problem.

Reference 1:

**     **

Reference 2:

**     **

Reference 3:

**     **

Reference 4:

**     **

Reference 5:

**     **

If you have published related papers, list up to five of these and
attach reprints.

Reference 6: **     **

Reference 7: **     **

Reference 8: **     **

Reference 9: **     **

Reference 10: **     **

7\. Material(s) to be examined: (Choose from the pull down menus.)

  ------------ ------------ ------------- ------------ ------------------
  Type         Form         Composition   Usage        Intended
                                                       Application

                                                       

  Other:       Other:       Other:        Other:       Other:      
  ------------ ------------ ------------- ------------ ------------------

8\. Is there any danger (to workers and/or equipment) associated with
the proposed sample or sample environment? Yes No

If yes, please specify risks below and how they will be managed.

> **     **

9\. Safety: Please check if any of the following apply to any of the
samples.

[Toxic]{.underline} [Corrosive]{.underline} [Radioactive]{.underline}
[Flammable]{.underline} [Explosive]{.underline} [Other]{.underline}

If any of these are checked, please attach MSDS or provide other
information.

**     **

10\. Previous Characterization:

> Please provide property and characterization data that have previously
> been collected that will help HTML staff understand the nature of the
> specimen. Include photos, graphs, micrographs, and tables or other
> evidence of microstructure of the samples. What additional
> characterizations will be done prior to your visit to HTML?
>
> **     **

11. Instruments Requested for This Proposal

[Instruments by Center]{.underline}

**Materials Analysis -- Larry Allard (865-574-4981) --
<allardfjr@ornl.gov>**

  ------------------------------------------ ---------- -------------------
  Instrument                                 Remote\*   Check All That
                                                        Apply

  Hitachi HF-2000 FEG-AEM                               

  Hitachi S-4700 FEG-SEM                                

  Hitachi FB-2000 FIB Micro Mill                        

  Hitachi S3400 Environmental SEM                       

  JEOL 8200 Electron Microprobe                         

  JEOL 2200FS-AC Aberration-corrected FE-TEM            

  JEOL 6500 Low-voltage Microprobe,                     
  Microcalorimeter EDS                                  

  Phi 680 FE -- Scanning Auger Nanoprobe                
  ------------------------------------------ ---------- -------------------

\*Remote access available, check if required.

**Diffraction (Neutron & X-Ray) Andrew Payzant (865-574-6538) --
<payzanta@ornl.gov>**

+-----------------------+-----------------------+-----------------------+
| Instrument            | Type                  | Check All That Apply  |
+-----------------------+-----------------------+-----------------------+
| X-ray Diffraction     | High-Temperature      | Temp:                 |
|                       |                       |                       |
|                       | Maximum temperature   |                       |
|                       | needed                |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Low-Temperature       |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Room-Temperature      |                       |
+-----------------------+-----------------------+-----------------------+
| Neutron\* Diffraction | 1600°C Vacuum Furnace |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Tube Furnace - 1200°C |                       |
|                       | (air)                 |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Room Temperature      |                       |
+-----------------------+-----------------------+-----------------------+
| Synchrotron High-Flux | RT Capillary Mount    |                       |
| Beam Line (at NSLS)   |                       |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Buehler Furnace       |                       |
+-----------------------+-----------------------+-----------------------+
|                       | Capillary Furnace     |                       |
+-----------------------+-----------------------+-----------------------+

\*Joint venture facility with Primary Funding for HFIR from DOE's Basic
Energy Sciences

Residual Stress/Texture -- Cam Hubbard (865-574-4472) --
<hubbardcr@ornl.gov>

+-------------------------------------+--------------------+-----------+
| Instrument                          |                    | Check All |
|                                     |                    | That      |
|                                     |                    | Apply     |
+-------------------------------------+--------------------+-----------+
| Neutron\* Diffraction Residual      | Large Specimen XYZ |           |
| Stress Mapping (Macro)              | Stage              |           |
+-------------------------------------+--------------------+-----------+
|                                     | Small Specimen     |           |
|                                     | KAPPA              |           |
|                                     |                    |           |
|                                     | 2-Circle Orienter  |           |
+-------------------------------------+--------------------+-----------+
|                                     | Load Frame         |           |
+-------------------------------------+--------------------+-----------+
| Neutron\* Powder Diffraction (High  | 1600°C Vacuum      |           |
| Temperature Furnace/Microstresses)  | Furnace            |           |
+-------------------------------------+--------------------+-----------+
|                                     | Tube Furnace -     |           |
|                                     | 1200°C (air)       |           |
+-------------------------------------+--------------------+-----------+
|                                     | Room Temperature   |           |
+-------------------------------------+--------------------+-----------+
| XRD X'Pert pro with Anton Paar Hot  |                    |           |
| Stage                               |                    |           |
+-------------------------------------+--------------------+-----------+
| XRD Polycrystal-Texture-Stress      | Rotating anode     |           |
| Goniometer                          |                    |           |
+-------------------------------------+--------------------+-----------+
|                                     | Standard X-ray     |           |
|                                     | tube               |           |
+-------------------------------------+--------------------+-----------+
| Synchrotron High-Flux X-ray Beam    |                    |           |
| Line                                |                    |           |
+-------------------------------------+--------------------+-----------+
| XRD TEC Large Specimen Goniometer   |                    |           |
+-------------------------------------+--------------------+-----------+

\*Joint-Venture facility with primary funding for HFIR from DOE's Basic
Energy Sciences

Thermography & Thermophysical Properties -- Ralph Dinwiddie
(865-574-7599) <dinwiddierb@ornl.gov>

  -------------------------------------------------- --------------------
  Instrument                                         Check All That Apply

  Differential Scanning Calorimeter -- DSC           

  Dilatometer - Bilayer                              

  Dilatometer -- Dual Push Rod (1500°C)              

  Dilatometer -- High Speed Quenching, Deformation,  
  or Cryogenic Cooling                               

  Dilatometer -- High Temperature (2400°C)           

  Electrical Resistivity                             

  Seabeck Coefficient Spectrometer                   

  Thermal Analysis -- Simultaneous DTA/TG/Mass       

  Thermal Analysis -- High Mass TGA                  

  Thermal Conductivity -- 3-Omega System             

  Thermal Conductivity -- Lock in IR Camera          

  Thermal Constants Hot Disk System                  

  Thermal Diffusivity -- Laser Flash                 

  Thermal Diffusivity -- Xenon Flash                 

  Thermography -- IR Camera offsite                  

  Total Hemispherical Emittance                      

  Hyperspectral Imaging offsite                      

  Thermosonic NDE                                    
  -------------------------------------------------- --------------------

Machining, Inspection, and Tribology -- Peter Blau (865-574-5377) --
<blaupj@ornl.gov>

  --------------------------------------------------- -------------------
  Instrument                                          Check All That
                                                      Apply

  Machining                                           

  Cincinnati Machine Sabre Multi-Axis Grinder         

  Compact Grindability Test System                    

  Instrumented K. O. Lee Vigor Creep-Feed Grinder     

  Instrumented Prolight 3000 CNC Turning Center       

  Instrumented Weldon Cylindrical Grinder             

  Instrumented Benchman 4000 CNC Machining Center     

  Precitech Optimum 2800 Ultra-Precision Turning &    
  Grinding Machine                                    

  Inspection                                          

  EMD Legend Coordinate Measuring Machine             

  Mahr Formtester                                     

  Nikon Optical Comparator                            

  KSI-2000 Scanning Acoustic Microscope               

  Rodenstock Model RM600 Laser Surface Profile        
  Measuring System (Noncontact)                       

  Taylor Hobson Talysurf Model 120 Stylus Surface     
  Profile Measuring System                            

  Friction & Wear Analysis                            

  Durometer -- Elastomer Hardness                     

  High-Temperature Oscillatory Scuffing Tester        

  Hysitron Triboindenter                              

  Image Analyzer                                      

  Microindentation Hardness Tester                    

  Multi-mode Rolling/Sliding Friction & Wear          

  Room Temperature Pin-On-Disk                        

  High Temperature Pin-On-Disk                        

  Low-load reciprocating friction/wear                

  High-load reciprocating friction/wear               

  Repetitive Impact Testing System                    

  Instrumented Scratch Test (Revetest)                

  Portable Scratch Test                               

  Continuous Loop Abrasion Test                       

  Subscale Disk Brake Material Tester                 
  --------------------------------------------------- -------------------

#  {#section .unnumbered}

**Mechanical Characterization & Analysis -- Edgar Lara-Curzio
(865-574-1749) -- <laracurzioe@ornl.gov>**

  ------------------------------------------------ ----------------------
  Instrument                                       Check All That Apply

  Biaxial Test System                              
  (Torsion/Tension-Compression)                    

  Dilor XY800 Raman Microprobe                     

  Dynamic Mechanical Analyzer                      

  Electromechanical Test System                    

  FEA/Reliability Analysis                         

  Flexure Test Facility                            

  Hardness Tester                                  

  Micromechanical Test System                      

  Nanoindenter                                     

  Resonant Ultrasound Spectrometer                 

  Servohydraulic Test System                       

  Tensile Test Facility                            

  Thermal Shock Facility                           

  Thermomechanical Analyzer                        

  Ultrasonic Modulus System                        

  Universal Test Machine                           
  ------------------------------------------------ ----------------------

12\. Total number of days requested for project: **  ** (Should not
exceed 10)

13\. Detailed Experimental Matrix

> Provide a detailed experimental test matrix in tabular form. The
> matrix must show:

 Planned experiments (for each instrument checked above give test
materials, temperature range, environment, other details about
experimental conditions and requested time on that instrument);

 Replicates (if any) or why no replicates are planned;

 If matrix is from a formal design of experiments, provide the
quantitative levels for each factor;

 Please discuss with HTML contact for each instrument to estimate time.

Table

**     **

14\. Previous Experience:

(List previous experience on each instrument requested in the
experimental plan.)

**     **

15\. Sample Preparation:

Users must bring fully prepared samples to the HTML. (Discuss
appropriate preparation techniques with HTML contact.) Exceptions can be
made on a case-by-case basis. HTML can provide some sample preparation
for a fee. If you feel you may need this service, please discuss with
your HTML contact. **[Users needing sample preparation must provide
up-front payment for this service.]{.underline}**

Need Sample Preparation

Do Not Need Sample Preparation

16\. Verification of non-competition: Please state, in your own words,
the reason(s) you propose research at the HTML. In order to satisfy our
non-competition requirement, your response MUST identify one or more
instrument capabilities or features of the HTML User Program that are
UNIQUE -- i.e., not available elsewhere. It is the policy of the HTML
not to compete with private companies that provide testing services. The
Department of Energy funds the HTML to complement the research
capabilities of U.S.-based industry and universities with unique,
state-of-the-art expertise and equipment.

The following are examples of appropriate responses: (a) The HTML User
Program allows our researcher to participate in the experiments as an
active, hands-on experimenter, and thus contributes to solving the
research problem and brings knowledge back to our organization; (b) The
HTML offers a unique combination of research instruments unavailable
anywhere else; (c) The HTML staff has essential expertise applicable to
our research problem; (d) Working with the HTML staff provides a
significant training or educational experience that is unavailable at
"for-hire" testing facilities.

**     **

17\. Intent to Publish

As a condition for performing no-cost nonproprietary research at the
HTML, the Department of Energy requires Users to publish any publishable
results from their research (this supersedes publication requirements of
other funding agencies). ***HTML technical staff must be listed as
co-authors and must be given an opportunity to review the publication or
presentation abstract prior to submission.*** The publication [must be
submitted within six months of completion of the research]{.underline}.
Results are typically published in peer-reviewed journals, proceedings,
or presentations at technical conferences. Proprietary Users are not
required to publish. Please provide a plan for publication in journal or
conference proceedings.

Title of Journal: **     **

Name of Conference: **     **

Date of Anticipated Submission: **     **

18\. Are you a past HTML User: Yes No?

If so, please list all prior user projects and the publications related
to your HTML User projects:

**     **

Credit Line

The following acknowledgement must be included in your publication:

*Research sponsored by the Assistant Secretary for Energy Efficiency and
Renewable Energy, Office of FreedomCAR and Vehicle Technologies, as part
of the High Temperature Materials Laboratory User Program, Oak Ridge
National Laboratory, managed by UT-Battelle, LLC, for the U.S.
Department of Energy under contract number DE-AC05-00OR22725.*

# Affirmation Statement

As Spokesperson, I agree to all terms specified in this proposal,
including the review of chemical hazards, verification of
non-competition, and intent-to-publish policies as described above. I
understand that the material to be published must go through the ORNL
publication review process before submission for publication.

**     **

Printed Name/Title

Signature/Date

Email to: <russellbj@ornl.gov>

+-------------------------------------+--------------------------------+
| **[Application for HTML User Badge  | Fax or e-mail completed form   |
| --- [If noncitizen, you must        | to:                            |
| include a copy of your passport,    |                                |
| VISA, and I-20 (if applicable), and | Billie Russell, HTML Program   |
| an [updated                         | Office                         |
| resume\']                           |                                |
| {.mark}]{.underline}]{.smallcaps}** | <htmluser@ornl.gov> (e-mail)   |
+-------------------------------------+--------------------------------+
| **[     ]{.underline}**             | \(865\) 574-1926 (phone)       |
|                                     |                                |
| (Date)                              | \(865\) 574-4913 (fax)         |
+-------------------------------------+--------------------------------+

***[Important: when you come to the visitor's portal for your very first
visit, please state that you are an HTML user (not a visitor). Please
indicate other ORNL programs with which you are affiliated (if any). All
Foreign Nationals must show passport and visa to gain entrance to ORNL.
Failure to provide proper documentation may result in denial of access
to the Laboratory.]{.underline}***

**Section A ([All]{.underline} applicants for HTML user badge) --- Print
or Type**

**[Complete]{.underline}** Last Name **     **, First Name**     **,
FULL Middle Name **     **Gender (M/F) **     **

Social Security Number **     **Date of birth **     **

Citizenship (if not U.S., please specify and fill out Section B
below)**     **

Home address **     **

City **     ** State **  ** Zip **     **Local phone number**     **

Are you currently a student? **     **University **     **

Degree you are pursuing **     **Major**     **GPA (4.0 scale)**     **

[Education:]{.underline} Highest degree **     **Year awarded**     **
Major**     **University**     **

Employer **     **

Employer address **     **

City **     **, State **  **, Zip**     ** E-mail address **     **

Employer phone **     **Employer fax **     **

Your present position/title **     **

Other ORNL programs you are affiliated with **     **

**Section B (Non-U.S. Citizens Only) --- Print or Type**

Place of birth (city, country) **     **, **     **

Country of citizenship **     **Are you an immigrant? (Yes/no) **     **

Do you currently live in the U.S.? (Yes/No) **     **

Passport number **     **Expiration Date (spell out exactly Month, day,
year **     **

Visa type **     **Visa number **     **Expiration date (day/spell out
month/year) **     **

[If a citizen of India or Pakistan, the following information must be
provided.]{.underline} Affiliation with any institute in home country?

\_ Yes No (if yes, who?)**     **

-   A badge application form must be completed for all who will be
    coming to conduct research.

-   Foreign Citizens --- Please attach a copy of resume\', passport,
    Visa, and I-20 documents. (Badges cannot be initiated until all
    documentation is received which will result in a delay in approval.)

-   Foreign Citizens must bring all documentation (passport, Visa, I-20,
    driver's license).

+--------------------------+-------------------------------------------+
| **[Application for HTML  | Fax or e-mail completed form to:          |
| User Badge --- [If       |                                           |
| noncitizen, you must     | Billie Russell, HTML Program Office       |
| include a copy of your   |                                           |
| passport, VISA, and I-20 | htmluser@ornl.gov (e-mail)                |
| (if applicable), and     |                                           |
| [UPdated                 |                                           |
| resume']{.mark}]{.u      |                                           |
| nderline}]{.smallcaps}** |                                           |
+--------------------------+-------------------------------------------+
| **[     ]{.underline}**  | \(865\) 574-1926 (phone)                  |
|                          |                                           |
| (Date)                   | \(865\) 574-4913 (fax)                    |
+--------------------------+-------------------------------------------+

***[Important: when you come to the visitor's portal for your very first
visit, please state that you are an HTML user (not a visitor). Please
indicate other ORNL programs with which you are affiliated (if any). All
Foreign Nationals must show passport and visa to gain entrance to ORNL.
Failure to provide proper documentation may result in denial of access
to the Laboratory.]{.underline}***

**Section A ([All]{.underline} applicants for HTML user badge) --- Print
or Type**

**[Complete]{.underline}** Last Name **     **, First Name**     **,
FULL Middle Name **     **Gender (M/F) **     **

Social Security Number **     **Date of birth **     **

Citizenship (if not U.S., please specify and fill out Section B
below)**     **

Home address **     **

City **     ** State **  ** Zip **     **Local phone number**     **

Are you currently a student? **     **University **     **

Degree you are pursuing **     **Major**     **GPA (4.0 scale)**     **

[Education:]{.underline} Highest degree **     **Year awarded**     **
Major**     **University**     **

Employer **     **

Employer address **     **

City **     **, State **  **, Zip**     ** E-mail address **     **

Employer phone **     **Employer fax **     **

Your present position/title **     **

Other ORNL programs you are affiliated with **     **

**Section B (Non-U.S. Citizens Only) --- Print or Type**

Place of birth (city, country) **     **, **     **

Country of citizenship **     **Are you an immigrant? (Yes/no) **     **

Do you currently live in the U.S.? (Yes/No) **     **

Passport number **     **Expiration Date (spell out exactly Month, day,
year **     **

Visa type **     **Visa number **     **Expiration date (day/spell out
month/year) **     **

[If a citizen of India or Pakistan, the following information must be
provided.]{.underline} Affiliation with any institute in home country?

\_ Yes No (if yes, who?)**     **

-   A badge application form must be completed for all who will be
    coming to conduct research.

-   Foreign Citizens --- Please attach a copy of resume\', passport,
    Visa, and I-20 documents. (Badges cannot be initiated until all
    documentation is received which will result in a delay in approval.)

+--------------------------+-------------------------------------------+
| **[Application for HTML  | Fax or e-mail completed form to:          |
| User Badge --- [If       |                                           |
| noncitizen, you must     | Billie Russell, HTML Program Office       |
| include a copy of your   |                                           |
| passport, VISA, I-20 (if | <htmluser@ornl.gov> (e-mail)              |
| applicable), and         |                                           |
| [updated                 |                                           |
| resume']{.mark}]{.u      |                                           |
| nderline}]{.smallcaps}** |                                           |
+--------------------------+-------------------------------------------+
| **[     ]{.underline}**  | \(865\) 574-1926 (phone)                  |
|                          |                                           |
| (Date)                   | \(865\) 574-4913 (fax)                    |
+--------------------------+-------------------------------------------+

***[Important: when you come to the visitor's portal for your very first
visit, please state that you are an HTML user (not a visitor). Please
indicate other ORNL programs with which you are affiliated (if any). All
Foreign Nationals must show passport and visa to gain entrance to ORNL.
Failure to provide proper documentation may result in denial of access
to the Laboratory.]{.underline}***

**Section A ([All]{.underline} applicants for HTML user badge) --- Print
or Type**

**[Complete]{.underline}** Last Name **     **, First Name**     **,
FULL Middle Name **     **Gender (M/F) **     **

Social Security Number **     **Date of birth **     **

Citizenship (if not U.S., please specify and fill out Section B
below)**     **

Home address **     **

City **     ** State **  ** Zip **     **Local phone number**     **

Are you currently a student? **     **University **     **

Degree you are pursuing **     **Major**     **GPA (4.0 scale)**     **

[Education:]{.underline} Highest degree **     **Year awarded**     **
Major**     **University**     **

Employer **     **

Employer address **     **

City **     **, State **  **, Zip**     ** E-mail address **     **

Employer phone **     **Employer fax **     **

Your present position/title **     **

Other ORNL programs you are affiliated with **     **

**Section B (Non-U.S. Citizens Only) --- Print or Type**

Place of birth (city, country) **     **, **     **

Country of citizenship **     **Are you an immigrant? (Yes/no) **     **

Do you currently live in the U.S.? (Yes/No) **     **

Passport number **     **Expiration Date (spell out exactly Month, day,
year **     **

Visa type **     **Visa number **     **Expiration date (day/spell out
month/year) **     **

[If a citizen of India or Pakistan, the following information must be
provided.]{.underline} Affiliation with any institute in home country?

\_ Yes No (if yes, who?)**     **

-   A badge application form must be completed for all who will be
    coming to conduct research.

-   Foreign Citizens --- Please attach a copy of resume\', passport,
    Visa, and I-20 documents. (Badges cannot be initiated until all
    documentation is received which will result in a delay in approval.)