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.

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
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 *
Test Method(s) *
Select one or more.
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
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.
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.
Results, Special Instructions, Timing
Finalize your request.
ETC Reference Job?
Final Technical Document? *
 Technical Report
Test Report Final Memo
Special Instructions
Enter any special instructions or additional notes here.
Estimated Receipt of Parts *
Desired Date for Results *
Attach Document
Attach a PDF or other document to this request.
Your attachment cannot exceed 1MB in size.
HOME | CONTACT US | RFE | LEGAL