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LDMRC EQUIPMENT USAGE FORM
Please be informed that we DO NOT entertain any urgent sample. Plan your work accordingly.
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* Indicates required question
Email
*
Your email
Application Date
*
MM
/
DD
/
YYYY
Please choose preferred analysis
*
HR-XRD
Contact Angle Measurement
Spin Coater
Impedance Analysis
IV Measurement
Required
Categories of Applicants
*
Choose
FYP Student
Postgraduate
Research Assistant
Lecturer
Research Officer
Science Officer
Industry
Others
Name
*
Your answer
IC No/Student ID No/Staff ID No
*
Your answer
Name of Supervisor (Put ONE name ONLY)
*
Your answer
Address Line 1 (e.g. Department of Physics)
*
Your answer
Address Line 2 (e.g. Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur)
*
Your answer
Phone No
*
Your answer
Email (Please type your email correctly as the quotation will be sending directly to this email)
*
Your answer
Sample Type
*
Powder
Thin film
Liquid
Other:
Required
No. of sample
*
Your answer
Notes (if any)
Your answer
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