Customer Work Request
University of Delaware, Department of Chemistry & Biochemistry
Scientific Glassblowing Shop - Brown Lab - Room 011 (302)-831-2463
Doug Nixon - Glass Technologist - dnixon@udel.edu
Customer Name_________________________________
Email _________________________________________
Date Submitted _________________________________
Phone # ________________________________________
Dept __________________________________________
Purpose Code ___________________________________
Building & Room #______________________________
Job Reference # (if applicable) ______________________
Faculty Advisor_________________________________
Explain work to be performed:
Bring a copy of this form to the glass shop to discuss your project. Please provide a sketch below or attach drawing.
PRINT FORM
Do not write in box below
Date Completed___________ Time Charged (hrs) _________ Materials Charged___________ Total Amount Billed_________
Materials Used: