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Request for Estimate
Please complete the form below as thoroughly and accurately as possible - note that all fields marked with an asterisk (*) are required for submission. Please upload/attach all protocols, prints, models, and all other pertinent documents via the link at the bottom of the page. If you have any questions regarding this form, please contact Empirical Testing Corp. at 719-264-9937.

1. Your Information: Enter your general contact information.

First Name *

Last Name *

Company *

Department

Position/Title

E-Mail Address *
Address Line 1

Address Line 2

City
State

Zip
Country

Phone Number *

Fax Number



2. Testing Parameters: Select the parameters in which you'd like us to test your system.

System Name

Device Type *
Indication Level *

Test Order
Test Type *



3. Test Method(s): Select one or more tests to perform.

ASTM F382
 ASTM F384
 ASTM F543
 ASTM F1717
ASTM F1798
 ASTM F2077
 ASTM F2193
 ASTM F2267
ASTM F2346
 ASTM F2423
 ASTM F2624
 ASTM F2706
ISO 7206-4
 ISO 14801
 ISO 7206-6
 ISO 7206-8
Expulsion
 Custom Protocol
 Other



4. Tests: Please indicate at least one desired test mode(s).

Desired Test? *
 Static
Dynamic
Test Mode
# of Specimens *

Comments?
Enter any comments regarding your tests.




5. Test Blocks & Fixtures: Please enter information about necessary test blocks and fixtures.

ETC Designs Test Blocks? *
 Yes
No
Maybe

If so, please provide solid models and/or prints of the device.
ETC Manufactures Test Blocks? *
 Yes
No
Maybe
Assemble Specimens? *
 Yes
No
Maybe

If so, please provide complete assembly instructions and custom instruments.
Comments?
Enter any comments regarding text blocks and fixtures.



6. Results, Special Instructions, Timing: Finalize your request.

ETC Reference Job?
Final Technical Document? *
 Technical Report
Technical Memo
Special Instructions
Enter any special instructions or additional notes here.

Estimated Receipt of Parts *

Desired Date for Results *

Attach PDF/Document
Your attachment cannot exceed 1MB in size.






Need an Estimate?

ETC is here to simplify your testing needs. Fill out our easy-to-use estimating form and we'll get back to you within 48 hours.



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 Contact Us

4628 Northpark Drive
Colorado Springs, CO 80918

Phone: 719.264.9937
Fax: 719.264.1926
info@empiricaltesting.com

719-264-9937



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