Request for GDMS analysis services under a blanket agreement

Please complete all required information on this form and submit it electronically. If you would like a response, please ensure you supply us with your fax number or email address.

Personal information

Order information

Your PO number, associated with the blanket agreement, is recorded for convenience of reference and for billing and tracking purposes only. The blanket order you signed with NRC acts as your acceptance of and agreement to be bound by NRC's terms and conditions. Your terms and conditions are not accepted by NRC. Please do not send us your PO documentation if already held on site at NRC.

Service Code Quantity Price Sample Type Sample identification numbers (ids)
A33-11-01-01 $535 CAD
A33-11-01-02 $685 CAD
A33-11-01-03 $600 CAD
A33-11-01-04 $ CAD

Total cost ($CAD):

Shipping information

Methods for receiving preliminary results

Specific Instructions:

All personal information created, held or collected by NRC is protected under the Privacy Act. This means that you will be informed of the purpose for which it is being collected and how to exercise your right of access to that information. You will be asked for your consent where appropriate.

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