Microscope booking form
Please fill out the following details if you would like to book the microscope.
User details
First name *
Your answer
Surname *
Your answer
Identity number *
(this is required for NRF reporting)
Your answer
Country of issue *
Your answer
Staff/student number *
Your answer
Email address *
Your answer
Cellphone number *
Your answer
Department and University *
Your answer
Current position *
Required
Supervisor *
Your answer
Fund number *
Your answer
Cost centre *
Your answer
Will you require assistance? *
If you answered "No" in the previous question, please state when you received training.
Your answer
Start of booking *
MM
/
DD
/
YYYY
Time
:
End of booking *
MM
/
DD
/
YYYY
Time
:
Sample and image information
Will you be using live cells? *
If yes, please specify cell type
Your answer
Fluorophore or chromophore that will be used
Your answer
Provide aim of your microscopy *
Your answer
Will you require the oil immersion ojectives (X60 and X100) *
Please inform us if you wish to purchase immersion oil from this facility.
Is your sample bio-hazardous? *
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