Analysis Request Form - particle size measurement Fill in the number of samples to be analyzed and press the update button: sizing choose analysis light scattering techniques imaging techniques other techniques choose type ....................................................         Description of sample(s):                         Your sample code(s)     Please fill in: aim of the analysis, special interest, estimated values, specified output (tailor made) etc.     Recommended storage: refrigerated ambient other?   Safety precautions: no safety precautions necessary toxic acid other?   Urgency: Standard (typically 2 weeks) Priority (40% surcharge) Customer information:   Name   *(mandatory field)     mr. mrs.   Company   Address     Phone   Fax   E-mail   *(mandatory field)   Your order number / reference   *(mandatory field)   VAT number (Dutch: BTW nummer) *(mandatory field)   Invoice address, if different from above:   We will store samples for three months, after which the samples will be destroyed. If you want us to return your samples, please tick the checkbox. Shipping costs will be charged.   Tick the checkbox to agree to the General Terms and Conditions of Delft Solids Solutions B.V. *(mandatory field)   Please send the printout of this form together with your samples.     signature (on printout): ..........................................................................

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Liability: Delft Solids Solutions B.V. total liability is limited to replacement, or refund of an amount, which will not exceed the sales price of services, rendered.
In no case Delft Solids Solutions B.V. will be liable for consequential or special damage even if Delft Solids Solutions has been advised of the possibility of such damage.

Confidentiality: Delft Solids Solutions B.V. respects our clients' needs regarding confidentiality; all results will be treated as such.