Chemical Storage Facility Chemical Request Form

The Chemical Storage Facility houses chemicals for research and academic use. In order to facilitate your order of chemicals, please fill out the following form and submit it. You will receive confirmation of your order and, providing we have the chemical in stock, we will deliver it within 24 hours.

If you DO NOT receive a CONFIRMATION SCREEN and a confirmation e-mail that your order was received, please contact Larry Miller at 622-6355.

STATUS

BILLING INFORMATION

Purpose for Chemical

MANDATORY.  ORDER WILL NOT BE FILLED IF YOU FAIL TO COMPLETE THIS SECTION.

Please choose ONE of the purposes below and fill out information for that purpose only.

CHEMICAL INFORMATION