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Philips
Phlips Intake Form!
Administrative data
Date:
Requested date of delivery:
Clarity Project number:
FUNLOC:
Costcentre or Projectnr:
Requester:
Requester e-mail:
Requester phone:
Organisation:
Address:
Priority:
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What do you want to know?
Tick only what is needed:
Integrated Light Properties
Light Distribution
Ray Sets Generation
Optical Bench Measurements/photo-biological safety
Material Characterization
Calibration of conventional lamps and luxmeters
Special Request
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Purpose of measurements
Tick only what is needed:
Characterisation
Lifetime
Product Release
Round Robin / Intercomparison
Golden Samples / Reference samples / Calibration Lamps
Customer Complaint
Other
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Sample information (Please make sure samples are uniquely identifiable)
Sample Description:
Upload Photo:
Dimensions of sample:
Dimensions information
Is Sample radiating in a hemisphere (2Pi)?
Yes
No
Fill in dimension of Circle/Rectangle?
Rectangle
Circle
Rectangle
Length(m):
Width(m):
Area(m2):
Circle
Radius(m):
Area(m2):
Fill in dimension of Box/Sphere/Cylinder?
Box
Sphere
Cylinder
Box
Length(m):
Width(m):
Height(m):
Area(m2):
Sphere
Radius(m):
Area(m2):
Cylinder
Length(m):
Radius(m):
Area(m2):
TO BE DONE IN A LATER PHASE. CHECK ILP FOR DATA.
Weight of sample including heatsink:
<5 kg
>5 kg and <5 kg
>35 kg
Have sample been aged?:
Yes
No
Is there a 190-sheet?:
Yes
No
Number of samples:
Additional Safety precautions required?
Yes
No
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