test form page Posted May 8th, 2014 by atmanager. New Sample Submission Form Online Sample Submission FormIf you have already received our quote and would like to submit your samples, please fill out and submit this form.Client InformationPayment Options*Credit CardPOPO Number*Credit Information*I'll CallCall MeRequestor*PositionCompany*Phone*FaxEmail* Address*City*State*Zip Code*Same Billing Address?*YesNoBill RecipientBilling Address*City*State*Zip Code*Background Information & Analysis RequestAnalytes to MeasureSample Matrix / TypeSample Size Available# of Samples SubmittedExpected ConcentrationsRequired Detection LimitSpecificationStorage Conditions*No special conditionsSpecial conditionsRequired conditionsProject GxP Status * If GMP or GLP is required, additional charges may apply and methods must be specified or included. For non-GxP testing, analytical results or data obtained are to be used for exploratory and development studies and are not intended for product release.Project GxP Status *Non GxPGMPGLPDescribe the testing you require and desired method of analysis (if known):Project Objective*Methods/Tests/CommentsList of Sample IDs*Return Sample? (charges may apply): *Return Sample? (charges may apply): *YesNo, disposeAdd shipping cost to my invoiceUse my shipping accountFedExUPSOtherAccount Number*Turnaround Time Requested: *Turnaround Time Requested: *Normal: 5-10 Business DaysRush: < 5 Business DaysPriority: < 3 Business DaysSurcharges apply for Rush and Priority.TERMS: Payment due upon completion of the tests and/or delivery of the results and subject to the standard terms and conditions of Alliance Technologies. Samples may be sub-contracted at the discretion of the laboratory. Submission of this form for testing services assumes agreement with these terms and conditions and the pricing information provided by Alliance Technologies, LLC.