Please fill out, print and sign this form, then send or fax it to: ASF User Services Office, UAF Geophysical Institute, PO Box 757320, Fairbanks, AK 99775-7320; Fax (907) 474-2665.

Today's Date (Y/M/D):
Last Name:
First Name:
Street Address:
Additional Address Line:
City:
State or Province:
Zip Code / Postal Code:
Country:
Phone:
Email:
Affiliation:
The following data set(s) are requested for testing purposes (Specific data must be identified by product ID):
A brief description of how I will use the test data:

I understand that the data I receive from the Alaska Satellite Facility can be used only under the following terms and conditions:

• The data are for my use for bona fide test purposes only. No commercial use is allowed of the data or any products derived therefrom. I agree that I will use the requested test data set(s) only for software or system testing. I further agree that I will not redistribute any or all of the requested data to third parties. In addition, I agree to report my test results back to ASF, particularly any difficulties I may have encountered in testing the data.
• The data will not be reproduced or distributed to any other parties, except that they may be shared among named members of my test team and with other collaborators who have a signed ASF Test Data Agreement of their own on file. I will be responsible for compliance with this condition for the data I obtain from ASF. I am further responsible for compliance to these agreement terms by members of my test team with whom I share these data.
• I will submit reports of my test results with the requested data, including derived data sets, and the algorithms and models used.
• I agree to provide, if requested, a copy of results obtained including derived data sets, algorithms, models, and documentation, to the ASF.
• I agree to pay the marginal cost to ASF of filling my specific requests including reproducing and delivering the data.
• I also understand that a product I produced from ASF data can only be freely distributed by me if it is in such a form that the original image data cannot be derived from it.

I understand that if these conditions are violated NASA may take appropriate action, including the following:

• 3.1 NASA Investigator: Termination of the research agreement, and potential loss of funding support by NASA. Subsequent access would be under terms for commercial use, as outlined by the respective flight agency.
• 3.2 Other Users: Termination of the research agreement, and notification by NASA to the investigator’s sponsoring agency and to the relevant space agency of the violation. Subsequent access would be under terms for commercial use, as outlined by the respective flight agency.

Signed:______________________________________________
Date:_____________________
Received for ASF by:____________________________________
Date:_____________________
Tracking Control Number (office use only):_________________