INDUSTRY USER ACCESS FORM
Hourly Access:
*
New
Renewal
FOR ADMIN USE ONLY
Online Safety Training
Drexel Visitor Access Form
FOM entry
Request for use of CRF Equipment:
*
Please Select
FEI ESEM/OIM
Zeiss FESEM
UV/Vis Raman
FTIR
Nanoindenter
SAXS/WAXS
XRD
JEOL 2100 TEM
Ultramicrotome
FIBSEM
XPS
Sample Prep
Other
User Full Name (First, Last):
*
Name of Company:
*
Department/Affiliation:
*
Please Select
Biology
Biomedical Engineering
Chemical and Biological Engineering
Chemistry
Civil, Architectural, and Environmental Engineering
Computer Science
Electrical and Computer Engineering
Food Science, Goodwin College
Materials Science and Engineering
Mechanical Engineering and Mechanics
Physics
Other
User Email:
*
Telephone:
*
Emergency Contact Info (full name and phone):
*
Company Manager: (Responsible for payment of equipment usage/training fees)
*
Department/Affiliation:
Please Select
Biology
Biomedical Engineering
Chemical and Biological Engineering
Chemistry
Civil, Architectural, and Environmental Engineering
Computer Science
Electrical and Computer Engineering
Food Science, Goodwin College
Materials Science and Engineering
Mechanical Engineering and Mechanics
Physics
Other
Company Manager Email:
*
Telephone:
*
Payment Options:
*
Credit Card
Check
From the rate schedule below, select Instrument:
*
Please Select
Zeiss FESEM, FEI ESEM/OIM (Assisted Use - $300/hr)
UV/Vis Raman (Assisted Use - $250/hr)
Nanoindenter (Assisted Use - $200/hr)
SAXS/WAXS/XRD (Assisted Use - $250/hr)
TEM (Assisted Use - $300/hr)
FIB (Assisted Use - $300/hr)
XPS (Assisted Use - $325/hr)
Sample Prep (Assisted Use - $200/hr)
Other
Training fees (Estimate only. Accounts will be charged for actual training time at the standard rate of $50/hour):
Please Select
SEM Training
Raman
Nanoindenter
SAXS/WAXS
XRD
TEM
FIB
XPS
Sample Prep
Other
** I agree to abide by all policies as indicated on the Drexel Core Facilities website .
*
Agree
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