REQUEST FORM FOR XPS/UPS/ISS ANALYSIS CONTACT INFORMATION Name:_____________________________________________________________________________ e-mail: _____________________________________________________________________________ Advisor:____________________________________________________________________________ SAMPLE INFORMATION Date submitted: ______________________________________________________________________ Synthesis or other preparation details. Is your sample electroconductive? The desired elements for High-Res data collection in addition to a “survey”? Other experimental details about data collection: Attach any literature data or publications. Attach pictures of your samples