CONTACT INFO * Required Fields | | |
Name:*
| Company:
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Purchase Order#:
| Phone:*
| Ext:
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Cell Phone:
| Email*:
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BILLING INFORMATION |
Name:*
| Address:
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City:
| State/Province:
| Zip code:
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Email:*
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SHIPPING INFORMATION |
Same as Billing? (Indicate Yes/No)
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| * Required if different from "billing info" and CANNOT be a P.O. Box |
Name:
| Address:
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City:
| State/Province:
| Zip code:
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PAYMENT METHOD |
Please indicate which payment method will be used
(Visa, MasterCard, American Express, Invoice, Grant or Check)
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If purchasing by credit card, we will complete order transaction via phone. Otherwise, an invoice will follow the shipped work within 5 working days to the "Bill To" recipient.
If printing and enclosing the form please complete the following information. |
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CREDIT CARD |
Please indicate card type (Visa, MasterCard, American Express)
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Credit Card No:
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Security Code:
| Expiration date:
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Name on Card:
| CC Billing Address:
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SHIPPING METHOD |
Please indicate which "Shipping Method" is preferred
(Ground, 2 Day, Next Day, Courier, or Customer Pick‐up)
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THIN SECTIONS |
Number of Samples:
Indicate Section Size: 27 x 46 mm (1”x2”) or 50 x 76 mm (2”x3”)
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Epoxy Impregnation: (Indicate Blue, Clear, Blue if needed, Clear if needed, None)
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Fluorescent: (Indicate Yes/No)
Microprobe Polishing: (Indicate Yes/No)
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Staining: Indicate Calcite (ARS), Iron Rich Carbonate (ARS & Potassium Ferricyanide), Potassium Feldspar, Plagioclase, No Staining)
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Full Stain: (Yes/No)
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1/2 Stain Vertical: (Yes/No)
1/2 Stain Horizontal: (Yes/No)
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Ground In Oil: (Yes/No)
Orientation: (Yes/No)
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Cover Slip? (Yes/No)
Extra Cutting: (Yes/No)
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TURNAROUND TIME |
Guaranteed Service: Please indicate best option
(4-Week Service / 20 Business Days [25% Upcharge])
(Rush Service / 10 Business Days [50% Upcharge])
(Super Rush Service / 2-5 Business Days [100% Upcharge])
(Drilling Well / 24 hours [200% Upcharge])
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Or choose Regular Service (Orders processed as they are received. Call for current times.). Just indicate YES in the box below:
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Special Instructions For Processing:
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SHIPPING PROCEDURES |
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Sample material should be individually wrapped and labelled and include a spread sheet with your samples, numbering each sample and labeling them for engraving purposes (not longer than 9 characters). Orders submitted without a spreadsheet are subject to a list fee of $1.00 per sample.
Mail Samples To:
National Petrographic Service, Inc.
1621 Cottonwood School Road
Rosenberg, Tx 77471
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