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CRF-Sample Analysis Form

The document is a requisition form for sample characterization at the Central Research Facility of Dr. Vishwanath Karad MIT-World Peace University. It outlines the necessary information required from the applicant, including personal details, sample characteristics, and payment information. Additionally, it specifies guidelines for sample submission and emphasizes the importance of proper handling and acknowledgment in publications.

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vivekkanzariya328
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34 views1 page

CRF-Sample Analysis Form

The document is a requisition form for sample characterization at the Central Research Facility of Dr. Vishwanath Karad MIT-World Peace University. It outlines the necessary information required from the applicant, including personal details, sample characteristics, and payment information. Additionally, it specifies guidelines for sample submission and emphasizes the importance of proper handling and acknowledgment in publications.

Uploaded by

vivekkanzariya328
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CENTRAL RESEARCH FACILITY

Department of Research and Development, Dr. Vishwanath


Karad MIT-World Peace University (MITW-WPU), Survey No,
124, Paud Rd, Kothrud, Pune, Maharashtra 411038 Bharat
Requisition Form for Sample Characterization

Name of the Applicant :


Designation : Dept./School:
Univ. / Industry / Instt.
:
Address
Contact Tel. / Mobile No. :
Email ID : @ .
Purpose (Select one) : UG  /M.Sc.  / MS  //M.Tech.  /B.Tech  / RA  /Ph.D.  /Other ______
Material: Measure Parameters:
Range: Temp. Rate:
Moisture: Temp. Range:
Precautions to be taken:
M.Pt / B.Pt: Any:
Details of the Sample :
Are the Samples, Magnetic: Yes,  / No, 
Techniques done in support of sample
requisition:
Technique-1: Technique-3:
Technique-2: No. of Samples: Max. 4
Nature of Sample : Powder/Polymer/Film/Crystal/Conducting/Biological/Other
Specific Type of Analysis,
:
If any, required
Data Collection / Format : Email  CSV /JPG/ PDF/ WORD/PNG:
TOTAL AMOUNT (Rs.) :
Challan No. : Bank:
Date of Payment :
Date of Application :
Signature of the Applicant : Date:
Signature of the
:
Project PI / Dean Date:
Approval of Dean, R&D : Date:
A) Maximum 4 samples will be considered for Characterisation at a time. B) Analytical charges are as per category are
available with R&D. C) For more samples, proper labelling must be ensured with solubility (only organic solvents). D) Do
not leave any item unfilled. E) Payment should be made through Bank Challan as per the details to the A/C No. Dr_______
VKMIT-WPU
A/C No. BOI 053010110013545
__________________________________Only. F) Please provide reference data, image, and published papers for best
results. G) Sample preparation is to done by user H) If the sample(s) present(s) any danger to the operator or
equipment then kindly provide appropriate handling instructions or stipulates any special treatment as protocol,
otherwise the user will be solely responsible for the damage done. I) The use of this facility must be acknowledged in
the publications/thesis/reports by the user and same should have been conveyed to us by emailing to _______________
@mitwpu.edu.in
Account Details: Bank Name: A/c. Name: Ac. No:

Transaction details :-

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