Sample characterization request form for Other Instruments

Fields marked with * are required Submission Guidelines


Sample Details:

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

Measurement Details:

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 (fill name of equipment/measurement) facility’.

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)*