Veltec Laboratories
Veltec Laboratories  | 12255 Universal Drive | Taylor, MI 48180-4072 | USA
 Phone (734) 946-0440 | Fax (734) 946-1435
 Hours: Monday-Friday 8 a.m. – 4 p.m.
TEST REQUEST FORM
OLD ct page - Veltec Laboratories

Customer Pick-Up / Order Form
Requested By*
(your name)
Company Name*
(or www.VeltecLabs.com account#)
Pick-Up Location*
Email Address*
Phone (main) ext
Phone (alternate) ext
When will the samples
be ready for pickup?
  View Calendar
Please list the samples for pickup below
Sample ID# ASTM
TYE		 JIS
TYE		 Chem Coating
Weight		 Other
1)
2)
3)
4)
5)
6)
7)
8)
Notes / Comments
Technical Phone/Fax Order
Phone (734) 946-0440
Fax (734) 946-1435