First name: *        Last name: *

* I agree to include the appropriate NRAO acknowledgement(s) in the text
of the paper for which I am requesting Publication Support.

Include the appropriate acknowledgement(s) listed below:

The NRAO Acknowledgment:

"The National Radio Astronomy Observatory is a facility of the National Science
 Foundation operated under cooperative agreement by Associated Universities, Inc."

The ALMA Acknowledgment (In addition to the above NRAO Acknowledgement):

“This paper makes use of the following ALMA data: ADS/JAO.ALMA# [Project code]. ALMA is a partnership of ESO (representing its member states), NSF (USA) and NINS (Japan), together with NRC (Canada) and NSC and ASIAA (Taiwan), in cooperation with the Republic of Chile. The Joint ALMA Observatory is operated by ESO, AUI/NRAO and NAOJ."

The NRAO Facilities Naming Convention:

• The “Robert C. Byrd Green Bank Telescope (GBT);” “GBT” in subsequent references
• The “Pete V. Domenici Science Operations Center (SOC);” “SOC” in subsequent references
• The “Karl G. Jansky Very Large Array (VLA);” “VLA” in subsequent references

Choose your affiliation: *

I am an NRAO Employee.

I am a Jansky Fellow. You are required to include the Jansky Affiliation:
     "Jansky Fellow of the National Radio Astronomy Observatory."

I am an NRAO Adjunct. If you list an NRAO affiliation, it must be:
     "Adjunct Astronomer at the National Radio Astronomy Observatory"

I am an NRAO Student.

I am working at a US institution but am not affiliated with NRAO.

None of the above applies.

Proposal Code(s): *

Examples: GBT = GBT/09A-040
                  VLA = VLA/07B-265 or AD432 (Legacy Code)
                  VLBA = VLBA/09C-146
                  ALMA = ADS/JAO.ALMA#2011.0.00191.S

* List additional Proposal Codes in the notes.
** Staff author papers without NRAO telescope data should use 0000.

arXiv Number: *

Grant Number: (NRAO Employees only. Grants administered by NRAO.)

E-mail address: *

Re-enter Your E-mail: *

Notes: