Designed Services Material Request Form

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Designed Services Material Request Form
G
I
:
J
ID#:
ENERAL
NFORMATION
OB
________________________
Company Name: ______________________________________________________________________
Contact Name: ______________________________________
Title: ___________________________
Email Address: ______________________________________ Phone #: _________________________
Alfa Rep Name: _________________________________ Email: _______________________________
M
I
:
ATERIAL
NFORMATION
Material description: __________________________________________________________________
Average particle size (min/max): ___________________
Particle Size Distribution: ________________
Solid
or dispersion
For Dispersions:
Particle Concentration Requirement: ____________
Target pH of dispersion (if aqueous): ________
Preferred solvent/matrix: _______________________________________________________________
Dispersibility (toleration of agglomerations to within what size?): _______________________________
Other Additives (Preferred or desired) in Dispersion:
Please identify any materials that would have adverse effects on your end product performance and
should not be used in the synthesis of stabilization of the nanoparticle and dispersion:
1

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