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CvSU MANUAL OF OPERATIONS
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                   Research Lab Form No. 1a

                          Request form for the use of laboratory facilities


                          (For University faculty members, staff and students)


                          Request Number: _____________________

                          Date Requested: ______________________

                          Name of Faculty/Staff/Student: _________________________________


                          Unit/Department-College: _______________________________________


                          Inclusive Dates of Use:  _________________________________________

                          Request:


                                 ____  Use of laboratory room  _____  Use of equipment

                                     ____    Use of glassware/s              _____  others, please specify
                          _________________

                          Details/Specifications of Request:


                          _____________________________________________________________________
                          _____________________________________________________________________
                          _____________________________________________________________________
                          _____________________________________________________________________
                          ________________


                          Recommending Approval:

                          ________________________

                          Department Chairman


                          Approved:


                          ________________________

                          Director for Research





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