New Customer

New Customer

New customers please complete the form below:

    Personal information:

    Company Name:

    Email Address:

    Phone:

    Fax:

    Address Line 1:

    Address Line 2:

    State:

    City:

    Zip Code:

    Primary Contact

    Full Name:

    Email Address:

    Phone:

    Administrative Contact

    Full Name:

    Email Address:

    Phone:

    QA/Cal Manager

    Full Name:

    Email Address:

    Phone:

    Calibration Requirements

    Track Equipment by:

    Service Requirements:

    ISO/IEC 17025 AccreditedNon-Accredited CalAccredited Calibration ISO 17025ANSI Z540.3NIST traceable calibration with data (ANSI Z540-1)NIST traceable calibration (No Data)PM (preventative maintenance) & Consulting ServicesRepair request/quote

    Other:

    Certificate Formatting

    Certificate Date Format:

    Calibration Interval:

    If an interval is chosen, how many months do you require?

    Notification of Equipment due for Calibration:

    Sticker Date Format:

    Delivery Information

    Ship via:

    Account #:

    Pick up and/or delivery location at your facility(if applicable): Yes

    Accounting Information

    Bill to same as ship to? Yes

    Address Line 1:

    Address Line 2:

    State:

    City:

    Zip Code:

    Purchasing Contact

    Full Name:

    Email Address:

    Phone:

    Accounts Payable

    Full Name:

    Email Address:

    Phone:

    Taxable?

    YesNo

    Tax Exempt ID:

    (Tax exempt certificate required by law.)

    Payment Method:

    Additional Requirements

    ACR Technical Services

    Where did you hear about us?

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      Your Name (required)

      Your Email (required)

      Your Message

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