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BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon 8700


Tel (088) 813-5661 to 5663; TeleFax (088) 813-2717, www.buksu.edu.ph
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BUKIDNON STATE UNIVERSITY BIOLOGY/CHEMISTRY LABORATORY


REQUEST FOR USE OF LABORATORY FACILITIES/EQUIPMENT

Date: _______________

Ms. AURFELI D. NIETES


Lab Coordinator
Bukidnon State University
Malaybalay City, Bukidnon

Dear ma’am,

May I/we, ________________________________________________________________________,


(Name/s)
___________________________________________________ respectfully request your good office
(Institution/Agency, Course, Position)
to allow me/us to use the __________________________________ and the equipment listed below:
(Name of laboratory)

_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
on __________________________ _______________________
(Date) (Time)

for the following reasons:


_________________________________________________________________________
_________________________________________________________________________________________
(*see attached copy of the thesis proposal approved sheet).

I/we agree that I/we will take full responsibility of the material and chemical wastes generated during
the course of experiments.

Hoping for your approval. Thank you.

Sincerely yours,

____________________ ___________________ ____________________


Requisitioner Requisitioner Requisitioner

Noted: Recommended:

AURFELI D. NIETES AURFELI D. NIETES


Thesis Adviser Lab Coordinator

Approved:

DESIREE CHRISTINE C. ARBUTANTE, MA


Chair, Department of Natural Sciences

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