Laboratory Work Order FAX Form

Company: _______________________________ 

Billing Address: ___________________________

Ship to Address: __________________________

City: _____________ Province: ______________

Postal Code: ____________________

Telephone: ____________  ext. _______ Fax: _________________

email: _____________________________________

Submitted by: ________________________

Alternate Contact Name: __________________

Return Specimens via: ______________________________________

Please specify standard practice (ASTM, Ford, GM, SAE etc.)
or specification to be followed:

_________________________________________________________

Number of specimens: ____________________________________

Specimen Identification: ________________________________

__________________________________________________________

__________________________________________________________ 

“Please send a purchase order with the test samples detailing the test
requirements. First time customers are C.O.D. and must complete a credit
application. Please contact one of our Customer Service Representatives
for more information. (Cambridge Div. (519) 621-6600 or
Mississauga Div. (905) 812-3856)” 

 

Authorization to perform test(s):

Client Signature: _________________________ Date: ___________________

Ship to: Cambridge Division Cambridge Materials Testing Ltd. 1177 Franklin Boulevard, Cambridge, Ontario, Canada   N1R 7W4

Mississauga Division Cambridge Materials Testing Ltd. Product Development / TSL 6991 Millcreek Drive, Mississauga, Ontario, Canada  L5N 6B9

             Attention: Your CMTL contact or Customer Service