CENTRAL ADVANCE RESEARCH ENABLER FACILITY FACULTY OF ENGINEERING, UNIVERSITY OF MALAYA

CENTRAL ADVANCE RESEARCH ENABLER FACILITY (CAREF) LABORATORY Level 2, Block M, Faculty of Engineering, University of Malaya (03-79676865)

Contact persons:

Technical Manager: Alias Bin Abdullah (03-79675323)

Supervisor: Mohd Nazarul Zaman Bin Mohd Nazir (+6019-6601776)

Booking Form and Quotation (SEM Tabletop)

Check List Document :

Booking Form and Quotation

Internal Money Transfer (e-finance – IPPP Grant) / Journal Transfer Form (HIR Grant)

PART A : Applicant Detail

Name Department

Matric No IC / Passport No

E-Mail Phone No.

PART B : Booking Information

Booking Date* Type of Analysis

Booking Times* No of sample

Claim From (grant)

Sample Description:

Total hour Charges RM50/hour

Total Charges RM

*Please get the confirmation of availability date at CAREF laboratory

PART C : Confirmation

I certify that this application is and all information herein is valid.

I understand that the CAREF laboratory reserves the right to approve, decline or cancel this application in the

interest of the Faculty of Engineering , University of Malaya.

I understand that the Laboratory staff has the right to hold my data or reject my next booking if the

payment has not been done.

I have read and fully understand the Terms and condition on page 2 of this form. By signing it, I accept the

conditions stated in that Terms and conditions.

Applicant

_____________________

Name :

Date:

Principal Investigator /

Supervisor

_____________________

Name & Position Stamp :

Date:

FOR OFFICE USE ONLY

Received by : .........................................

Date : ........................................

Approved by: ........................................

(TM / Technical Staff)

Date : ........................................

CENTRAL ADVANCE RESEARCH ENABLER FACILITY FACULTY OF ENGINEERING, UNIVERSITY OF MALAYA

CENTRAL ADVANCE RESEARCH ENABLER FACILITY (CAREF) LABORATORY Level 2, Block M, Faculty of Engineering, University of Malaya (03-79676865)

Contact persons:

Technical Manager: Alias Bin Abdullah (03-79675323)

Supervisor: Mohd Nazarul Zaman Bin Mohd Nazir (+6019-6601776)

TERMS AND CONDITIONS:

1. Please submit this form together with Internal Money Transfer (e-finance – IPPP Grant) / Journal

Transfer Form (HIR Grant). 2. Kindly return, the original copy of this Request Form to the CAREF Laboratory.

3. Registered users are allowed to book maximum four (4) hours per week with the total of 12 hours per

month usage.

4. Please put your samples in plastic pack with proper labeling and send to the laboratory personnel.

5. Do not leave your sample within laboratory after you have done your analysis.

6. Please clarify if your sample is toxic/hazardous to health.

7. Payment term is 100% upon agreement and the payment must be made within fourteen (14) days after

services given.

8. Any cancellation has to be made two (2) days earlier before the date of booking. For those who failed to

do so, they will be charged based on hours of lab booking.

9. The laboratory has the rights to reject the test request. No fees will be charged if the test is rejected.

10. Payment shall be made in the form of a crossed cheque to ‘Bendahari Universiti Malaya’. CIMB Bank

Account number: 8001279998 or Transfer journal to account J-16001-76591(Central Lab Facility –

Faculty Engine).

Thank you for your cooperation.