NCTU Nano Facility Center - User’s Information (Form B)

(For non-faculty and non-student applicants only) Date: (yy/mm/dd)

Tool Name / Access Class
Full Name / Job Title / Phone
Affiliation / Employee ID number
Superintendent’s Signature / NFC Contact Person (Signature)
Substrate Material / Process Material
Note: Brief the purpose of using this tool.
(use backside for additional space if necessary) / Verification result by tool owner:
□ Approved
□Temporarily unapproved due to lack of information
□ Unapproved
Comments:
Tool Owner’s Signature: ______
Date:______(yy/mm/dd)
Application flow：（please print the date for each item）
1.advisor：approval.（submit the signed form to NFC representative）
2.NFC representative：to confirm the general training has been taken.
3.trainer：to sanction the training by qualified users. The form is to be signed by trainer after the training.
4.Examiner：the examiner is to be assigned by NFC.
The form is to be signed by the examiner followed by the technician. ※Use one form for each tool.
※The trainer is allowed to start the training only after the form is signed by NFC representative.
Training record：(Need training more than three times)
Date and time / Signature of trainer / Date and time / Signature of trainer
1 / 6
2 / 7
3 / 8
4 / 9
5 / 10
Payment of examination fee NT$300：
Confirmation of examiner
◎Access card number:
Instruction（Please indicate the date of each approval）
1. Advisor approval. (After being signed by the advisor, pass it on to NFC staff.)
2. NFC staff: Confirmthe passing of the general training and examination by the applicant.
3.Tool owner: According to process instruction, decide whether the applicant is capable of operating the tool alone.
4.Trainer: Approve qualified student to be trained, notify the technician to co-sign. Both trainer and technician need to sign here after finishing the training.
5. Examiner: Examiner is arranged by the Center. After being signed by the examiner,the technician needs to co-sign here to confirm.
※ One form should only be used for one tool.
※ The signature of tool owner is required for trainer to startthe training procedure.

製表日期:105年5月23日