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

Add an attachment?

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