U.S. Geological Survey, Woods Hole Science Center

Archival Policies and Collections Database for the Woods Hole Science Center's Marine Sediment Samples 2007, Version 1.0

Outgoing Loan Agreement Form

Sample Number: _____________

Collecting Scientist: __________________

Field Activity Number: ______________

Description of Sample:

Purpose for Sampling:

___	research
___	identification
___	other: ___________________________________________________

Length of Loan: ________________________________________________

Loan is to:

Name, title	___________________________________________
Institution	___________________________________________
Address	___________________________________________
City, State, zip	___________________________________________
Phone	_____________________
Email	___________________________________________

Loan Approved by:

_________________________________________________________________________________
Core Curator Signature and Date

_________________________________________________________________________________
Chief Scientist Signature and Date

_________________________________________________________________________________
Borrower Signature and Date

Loan Returned by:

_________________________________________________________________________________
Core Curator Signature and Date

_________________________________________________________________________________
Chief Scientist Signature and Date

_________________________________________________________________________________
Borrower Signature and Date

Description of analyses, tests and all alterations made to the sample(s):

U.S. Geological Survey
Woods Hole Science Center
384 Woods Hole Road
Woods Hole, MA 02543