IMS- Micro/Nano Fabrication Facility
Service and Repair Request
Contact Information
First Name
Last Name
Email
Phone
School/Department/Company
Inter-departmental Equipment Service Request
Please enter contact information
Name Phone number  Email address
Contact Information
What procedure are you requesting? Please select one of the following:
Diagnostics/Troubleshooting
Repair
Installation 
Decommissioning/Removal
Commissioning/Startup
What is the make, model and serial number of the piece of equipment?
Make Model Serial Number Process Equipment Performs (deposition,etching,etc)
Equipment #1
Equipment #2
Equipment #3
Please provide a short description of the problem.
When would you like for the IEN Technical Staff to be on-site for consultation?
Where would you like to meet the IEN staff member for consultation?
Building Name   Floor Number   Room Number 
Location
Contact Information
Institute for Electronics and Nanotechnology
Georgia Tech
345 Ferst Drive, Atlanta GA, 30332

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Georgia Institute of Technology
Shared User Management System
791 Atlantic Drive
Atlanta GA 30332-0269 
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