The Research Affiliates Program

Registration Form and Confidentiality Agreement

for Subscription Level Memberships

Please fill out this form if you would like to register to become a member of The Jackson Laboratory Research Affiliates Program. Once you have completed the form, click on the "Submit" button at the bottom of the screen.

Your name:
Title:
Company Name:
Department:
Address:
Address:
City:
State:
Zip or Postal Code:
Country:
Tel:
Fax:
E-mail:
Name of Primary Contact Person at your company:

NOTE: The Primary Contact Person will receive all written communications from The Jackson Laboratory that are relevant to the Research Affiliates Program. Additionally, the Primary Contact Person must authorize use of the program services by any other company personnel. Only authorized users will be given access to the services provided by this program.

I authorize the following people to use the services provided by membership in the Research Affiliates Program at The Jackson Laboratory:

Name:
E-mail:
Name:
E-mail:
Name:
E-mail:
Name:
E-mail:

If you would like all employees authorized to use the service, please check here:
Form completed by: Date:

Please Review our Confidentiality Agreement

Your Membership gives you Facilitated Access

  • Exclusivie "Easy Access" web link to various resources provided by The Jackson Laboratory
  • Facilitated Access to Genomic and Genetic Information
  • Reduced registration rate to attend The Jackson Laboratory’s Courses and Conferences
  • A dedicated 24-hour turnaround email hotline

For pricing information, please contact:

Teresa Chu, Ph.D.
Scientific Liaison, The Research Affiliates Program
The Jackson Laboratory
610 Main Street
Bar Harbor, ME 04609
Tel: (207) 288-6775
Fax: (207) 288-6152
Email: tchu@jax.org