Welcome to Foragelab

ACCOUNT APPLICATION:

BILLING INFORMATION
Use Billing Information
Business Name *	Required
Client Name *	Required
Address *	Required
City *	Required
State/Province *	Required
Postal Code *	Required
Country *	Required
Phone
Email	Invalid email id
Fax
Billing Method *	Email Mail**

WHERE TO SEND RESULTS
Use Billing Information
Business Name *	Required
Client Name *	Required
Address *	Required
City *	Required
State/Province *	Required
Postal Code *	Required
Country *	Required
Phone
Email	Invalid email id
Fax
Reporting Method *	Email Mail Fax

**Available to US clients only. Changes to this information are the responsibility of the account holder.
CVAS billing terms are net 30. An annual late charge of 18% will be charged on any balance over 30 days due.

Invoices are generated on approximately the 1st and 15th of each month. PAY FROM THE INVOICE. Statements are generated on the 28^th of each month ONLY if there is a past due balance. If you have billing questions or concerns, please contact us at accounting@foragelab.com.

If my account is not paid in a timely manner and it becomes necessary to refer my account to a collection agency, I understand that I will be responsible for all collection agency fees to include reasonable attorney fees and court costs.

By signing below, I am acknowledging my understanding of the above information.

Name:

Date:

Signature:

(Or)

ACCOUNT AUTOMATIC COPY

CVAS Provides each account the option of having one person receive a copy of every report.

Business Name
Address
State/Province, Postal Code
Phone
Fax

Client Name
City
Country
Email
Reporting Method	Email Mail Fax

A starter kit consisting of 20 sample bags, 10 US Postal Mailing Labels, 5 UPS Group Labels, 3 UPS Red Overnight Labels, a brochure with a price list and testing information will be mailed to you (For US customers only). Please select the CVAS lab location that you would like to have your labels addressed to.

Waynesboro, PA

Batavia, NY

Madison, WI

Zumbrota, MN

Fort Loramie, OH

If persons other than those listed above are authorized to submit samples to this account, please include that information on next section below.

Thank you for choosing CVAS, we look forward to serving your analytical needs.

PERSONS AUTHORIZED TO SUBMIT SAMPLES TO THIS ACCOUNT

*Required Information
**Available to US clients only

Business Name
Address
State/Province, Postal Code
Phone
Email

Client Name *
City
Country
Fax
Reporting Method	Email Mail Fax

ACCOUNT APPLICATION:

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