Cal-Chek Canada

Calibration Order Form

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Company *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Lab Location (If Different Than Above)
Contact Name *
First Last
Email *
Phone *
### - ### - ####
Fax
### - ### - ####
Hours of Operation *
Do you require a Purchase Order? *

Yes

No
Purchase Order # (If Required)
Item(s) to be Calibrated *

Same as Last Year

Other (Please list below in Comments/Notes)
Comments/Notes
*** Optional Only ***

Some firms have staff on duty (or can have staff present) during a Saturday and/or Sunday. If prearranged, would it be possible for our service technician to calibrate your machine during either day? If so, please mark the appropriate box(es) and fill in the contact information. Please note: Approximately 2 or 3 days notice will be given.
Saturday

Sunday
Contact Name
First Last
Phone (If Different Than Above)
### - ### - ####
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