E95-001 Shift Assignment Form

Please fill out this form and submit it with the 'Submit your dates' button. You will receive confirmation of your submission by e-mail at the address you specify. Please sign up for 8 or more shifts over the course of the experiment. The experiment will begin on Wednesday, January 20th, 1999 and end on Sunday, February 28th, 1999.

If you have special requests for your shifts, please e-mail black@mitlns.mit.edu.

Finally, click here to check the last schedule and availability for your request before submitting your dates.

DomeBedroom
 


Last name :
First name :
Middle name :
Institution :
Address :
City, State :
Zip Code :
Country :
Phone :
Fax :
E-mail :
Total number of shifts :
Shifts starting : and ending : Shift preference : Number of shifts :
PERIOD #1 :
PERIOD #2 :
PERIOD #3 :
PERIOD #4 :
PERIOD #5 :
If you need more periods, please submit another form
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