Cleanroom Request Form | UConn IMS Cleanroom

Complete this form to arrange training and/or access to the Cleanroom at UConn IMS

"*" indicates required fields

Date*

Enter today's date

Name*

First Last

Company*

Email*

Phone*

User Status*

New User (Training required)

Existing User (Training on specific equipment may be required)

Instrumentation/Equipment*

List the instrumentation/equipment you are requesting to use or be trained to use.

What is your training status for this instrument/equipment?*

Require Training

Completed Training

Specific Request*

To help ensure that you are seeking training for/use of the appropriate instrumentation/equipment, please briefly describe what you are seeking to do with the instrumentation/equipment. Describe your substrate(s), the quantity and size, the materials on or inside your substrate, and any other relevant information.

Payment:*

How will you pay for usage time?

KFS Account (internal users)

Purchase Order (external users)

Credit Card (external users)

Name

This field is for validation purposes and should be left unchanged.