Requestor Information Last Name: Empl ID: First Name: UANet ID: Department: Phone #: Select a 4-digit Pin for swipe card access. Pin: Position: Advisor Information N/A Last Name: NMR Account Request Form First Name: UANet ID: Department: Phone #: Requestor's Signature Date Advisor's Signature Date www.chemistry.uakron.edu/magnet [email protected] By signing, the requestor agrees to abide by the NMR Facility and The University of Akron's rules and regulations. If not applicable is checked in advisor section, requestor agrees to be responsible for the costs mentioned below. By signing, the Advisor agrees to be responsible for the cost of repair not covered by warranty or service agreements, should there be any damage caused by the requestor. ADMINISTRATIVE USE ONLY below this line. Solid-State Solution User ID: PID: GID: 300 Gemini 300 Mercury 200 Chemag 200 INOVA NMR IT Manager Date NMR Lab Manager (Solutions) Date NMR Lab Manager (Solids) Date 400 INOVA 750 INOVA ___________ ___________
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