GBMC Slide Application This application is for additional testing related to the GBMC Slide Project. Step 1 of 7 14% General Information1.1 Applicant's InformationApplicant's Email* Enter Email Confirm Email Applicant's Phone NumberApplicant's Title/Position in Agency Applicant/Agency Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Applicant's Supervisor's Name Supervisor's Phone Number 1.2 Agency ResourcesIs this case still prosecutable under your state's statutes and local standard operating procedures? Yes No Are all major witnesses still alive and willing to testify? Yes No Please explain:* 1.3 Unit/Lead Investigator InformationCurrent Investigator's Name First Last Current Investigator's Phone NumberCurrent Investigator's Email Agency/Department with current jurisdiction: Shipment Number Located on the Bode Case Status Report. Case Information2.1 Victim InformationBode Case Number Located on the Bode Case Status Report.Agency Case Number Dr. B's Case Number Located on the Bode Case Status Report.Race/Ethnicity Gender Is this case also associated with a homicide?* Yes No Age at time of death Cause of death Date of Incident MM slash DD slash YYYY 2.2 EvidenceIs there a person of interest in this case? Yes No Do you have a DNA sample from the person of interest?* Yes No Are they still alive?* Yes No What's their age?* Has unknown suspect DNA been discovered? Yes No If yes, has unknown suspect DNA been entered into CODIS? Yes No Please provide additional explanation why the sample has not been uploaded to CODIS. Please select the relevant CODIS database(s) the sample is uploaded to.If you are unsure, please consult with your local or state lab's CODIS administrator. LDIS SDIS NDIS Please provide details on what additional testing is needed:*How do you believe this funding and the testing/services listed above will help in this investigation? Vendor/Quote Information3.1 Vendor InformationVendor/Company Name Contact Person First Last Phone NumberEmail 3.2 Quote InformationPlease upload vendor quote (max: 10 files) Drop files here or Select files Max. file size: 50 MB, Max. files: 10. Does this quote list all testing services expected to be funded by the SOJ Breitlight Justice Fund? Yes No Please click here to review the waiver.CAPTCHA
