Memorandum-天祥集团.doc

普通测试申请表 General Testing Requisition Form Form No.: Applicant Name (Payer): _________________________________________________ Official Use Only 申请单位名称（付款单位）: _________________________________________________ Rpt. No. : Address: _______________________________________________________________ 申请单位地址: __________________________________________________________ Contact Person 联系人: ___________ Telephone 电话：__________________ Fax 传真：__________ 邮编：______ Report Address 报告寄往:_______________________________________________ Email地址:_________________ Company Name Address shown on Test Report (if different from the Applicant Name Above): 测试报告上所注明的单位名称及地址（如果与以上申请单位不符）： Sample Description 样品描述 Item/Article/Model/Style No. 式样编号 Qty. of Sample Submitted 样品数量 Buyer 买家 : ____________________________________ (可不填） P.O. No.:_________________________ Supplier/Vendor/Manufacturer供应商/贸易商/生产商:________________________________________________________ Goods Exported to 产品运往：___________________ Country of Origin 原产地: ________________________ Test(s) Required (Please tick appropriate boxes) : 测试要求 Please select the test from the listed standard as attached, if it is not in the list, please indicate the test standard or test method in this form. 请从所附的标准清单中选取测试标准，若不在其中，请在此注明测试标准或方法。 Service Required: ( Regular 普通件 ( Express (40% surcharge) 加急件 ( Shuttle (100% surcharge) 特急件 Report Service : ( Fax 传真 ( Mail 挂号信 ( Express Mail 特快专递 ( Self Pick-Up 自取 Return Sample: ( Yes ( No * Notice: Samples not destroyed during testing may be reclaimed if so written down on the application form and will only be retained for a period of 30 days. (测试完成后,如需退回样品, 请在报告签发之日起30天内来实验室凭报告号码提取。) 是否同意个别项目分包天祥集团内部其他实验室（Some of tests above will be subcontracted to Intertek Testing Services labs.） ( 同意 （Agree） Confirmed by ） ( Telephone ( Email ( Fax ( Other ( 不同意