Sample characterization request form for AFM

Fields marked with * are required Submission Guidelines

Sample Details:

Sample Name* Sample Constitution/Composition*
No of samples* Usage hours (if known)
Sample State* Dimension of Sample

Measurement Details: Sample requirement guideline

Measurement mode* : Scan area (In micro meter) :

Mode of data delivery : email


Samples are to be returned* : Are you coming in person?* :
If Yes & Samples to be sent by post, Charges Rs 70 will be extra
Any other Information

I hereby declare that above information is correct to my knowledge and no further claim shall be made other than the above mentioned. I also declare that the samples submitted or their by-products obtained during the measurement are not toxic / inflammable/radioactive/ biologically hazardous. Samples are liable to be destroyed /disposed off after measurements and if to be returned, they have to be collected in person.

I agree to acknowledge the facility If the data are used in publications or thesis in the format, ‘CeNS, Bangalore is acknowledged for providing Atomic Force Microscope’.

I have read the Submission Guidelines & Sample requirement guidelines


User Details:
User Category* Contact No*
User Name* Email*
Designation* Signature*
Official Address* Address for Receipt
(Billing Address)*