NPL ENVIRONMENTAL RADIOACTIVITY PROFICIENCY TEST EXERCISE 2011 Enquiry Form Please complete this form, saving a copy for your own records and e-mail to radioactivity@npl.co.uk CONTACT/COMPANY DETAILS Contact Name: Tel: Fax: Email: Additional Contact: Tel: Fax: E-mail: Company/ Organisation Name: Company Invoicing Address: Delivery Address: (If different from above) NUMBER OF SAMPLES REQUIRED COST EACH (please indicate) Alpha High (AH) Alpha Low (AL) Beta 1 (B1) Beta 2 (B2) Gamma High (GH) Gamma Low (GL) Synthetic Sand (S) Participation Fee Despatch costs are extra and will be advised £375 £375 £375 £375 £375 £375 £375 £150 TBA Please Note: It is the responsibility of the receiving organisation to ensure all the necessary permissions or licences are in place to hold the material at the destination site before receipt is arranged. A quotation will be issued on receipt of this form.