INSTRUCTIONS FOR COMPLETING REAGENT ORDER FORM

Please complete the form according to the following instructions.  Incomplete or incorrectly filled out forms will delay shipment and may result in errors.  Please print legibly or type all information.

1.  The name of a contact person and a complete street address and zip code are required.  Please DO NOT use P.O. Box numbers.

2.  If you have previously ordered reagents or supplies from the NVSL, please complete this section.  If you are a new customer, a laboratory number will be assigned.

3.  A telephone number is required.  No orders will be shipped unless a telephone number is provided.  Please provide a FAX number if one is available.

4.  This section is to be completed by the NVSL.

5.  Payment may be made by charging to an NVSL user fee account, a credit card, or paying by check or money order.  Please fill in any applicable information.  Checks or money orders should be made payable to "USDA" in U.S. dollars.

6.  The reagents and supplies requested section must include the reagent code number, reagent or item name, and the quantity requested. 

7.  The name of the person (print or type) authorizing the request.

8.  The telephone number of the person authorizing the request.