Pipette Calibration
Equipment
Quantity
No.per year
Mail-In or Onsite
Type of service
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
Single-channel
8-channel
12-channel
16-channel
24-channel
Bottle-Top Dispenser
Syringes
Other
2-year
Annual
Bi-Annual
Quartely
Monthly
One-time only
Other
Mail-In
Onsite
+
Additional Line
Notes / Comments:
Address
Account #:
Company:
Department:
Title:
Mr
Mrs
Dr
Prof
First Name:
Last Name:
Street:
City:
State:
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Mandatory Fields