ICMS-F-017-Instrument-Reservation-Application-實驗室儀器預約使用表.docx

ICMS Instrument Reservation Application 實驗室儀器預約使用表 ICMS Instrument Reservation Application 實驗室儀器預約使用表 Requester Name Supervisor Requester Name Supervisor Student ID Email Student ID Email Instrument Name Model Instrument Name Model Assign Date (年) (月) (日) 至 (年) (月) (日) Justification Assign Date (年) (月) (日) 至 (年) (月) (日) Justification Requester Signature Instrument Assistant Signature Requester Signature Instrument Assistant Signature _________________________ _________________________ _________________________ _________________________ Date: ____________________ Date: ____________________ Date: ____________________ Date: ____________________ Remarks: Please send the request to instrument assistant and lab technician for approval at least one day in advance of using the instrument. E-mail confirmation and/or approval confirmation receipt will be send to the requester. ______________________________________________________________________ Remarks: Please send the request to instrument assistant and lab technician for approval at least one day in advance of using the instrument. E-mail confirmation and/or approval confirmation receipt will be send to the requester. ______________________________________________________________________ Approval Confirmation Receipt (For office use) Approval Confirmation Receipt (For office use) ________________ and ________________ is(are) approved to use ________________ and ________________ is(are) approved to use ______________________ from _____/_____/_____ to ____/____/____ for ______________________ from _____/_____/_____ to ____/____/____ ____ days. for ____ days. ________________________ _____________________________ Lab Technician Signature Date ________________________ Lab Technician Signature ________________________ Date