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University of Science and Technology of Southern Philippines

The document is a laboratory utilization request form from the University of Science and Technology of Southern Philippines. It requires requestors to provide their name, the laboratory and date needed, the purpose and activity, a list of required machines or equipment, and signatures. Requestors pledge to follow all laboratory policies to preserve the facility and equipment. The form needs approval from the attending laboratory technician and director of the laboratory management office.

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49 views1 page

University of Science and Technology of Southern Philippines

The document is a laboratory utilization request form from the University of Science and Technology of Southern Philippines. It requires requestors to provide their name, the laboratory and date needed, the purpose and activity, a list of required machines or equipment, and signatures. Requestors pledge to follow all laboratory policies to preserve the facility and equipment. The form needs approval from the attending laboratory technician and director of the laboratory management office.

Uploaded by

emem
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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University of Science and Technology of Southern Philippines

Alubijid | Cagayan de Oro | Claveria | Jasaan | Oroquieta | Panaon

LABORATORY UTILIZATION REQUEST FORM

Name of Requestor: ___________________________________ Date: ________________

Name of Laboratory: ________________________________ Date of Use: ________________

Purpose: ___ Instruction ___ Research ___ Extension ___ Skills Training ___ Others, specify ____________

Name of Activity: ______________________________ Time Start: _______ Time End: _______

List of Machine / Equipment / Instrument Needed

Machine / Equipment / Instrument Quantity Remarks

The undersigned requestor hereby pledged to abide to all laboratory policies and guidelines set by the University for the preservation and
protection of the laboratory facility together with all the machines / equipment / instruments found within it.

____________________________________ ______________________________________
Name and Signature of the Requestor Name and Signature of Requestor’s Supervisor

Approved:

____________________________________ FLORETO B. QUINITO, JR. MSIT


Attending Laboratory Technician Director, LMO

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