J105 SIMS Equipment Demo Form

General Information

Name *

First

Last

Email *

Email

Confirm Email

Phone *

Company / Institute *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Sample Information

Sample Description *

Please provide as much information as possible. The more information you provide, the better and more accurate our analysis is likely to be.

Storage requirements *

Please provide information on how your sample(s) should be stored. Unfortunately we are unable to store samples at -80°C.

Analysis requested *

Please specify the type of result you would like to get from this analysis. We may provide more than this, but it is very helpful to know your priorities.

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

You can also upload additional information such as images, papers, etc. Allowed file formats include .jpg, .png, .pdf, .ppt, .docx, .xlsx.

Sample Disposal / Return *

Please return my samples when finished.
Please dispose of my samples when finished

Short description (for Customs) *

Harmonised System (HS) code

Instructions for sample disposal *

Please provide details instructions about how to dispose of the sample(s).

General Information

Sample Information

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