Kansas City Calibration Labs, Inc
8391 Melrose Dr., Lenexa, KS 66214
(913) 541-0629  fax (913) 541-1930 toll free 1-888-541-0629

Please help us in processing your equipment in a quick and timely manner by filling out the following information about you and your equipment.  Then submit the form by printing it off and included it with your shipment or by bring it in with you.  We accept already established accounts all others are COD.  If you wish to try  establish an account please fill out this credit application.

Bill To:
Company:   
Address:
Address 2:
City:
State:
Zip:
Contact:
Phone:
Fax Number:
E-Mail:
Ship To:
Company:
Address:
Address 2:
City:
State:
Zip:
Contact:
Phone:
Fax Number:
E-Mail:
Service ItemNeeded Time Between Calibration:     90 Days    6 Months     1 Yr      2 Yr
Purchase Order: Manufacture:
Ship Via: Model:
Need Estimate: Yes   No Serial Number:
Turnaround Need: NEBB Certification: No  
Payment Type: Credit Card  On Account (Already                                                                    Established)    NIST Certification: No  
Any additional comments: