Lab Services

Testing Request Form

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Testing Request Form

Testing Request will be reviewed by the Program Director. You will be contacted by the Program Director to discuss/schedule.

Form must be filled out for each of your products you wish to perform testing on and perform testing to.

GENERAL REQUEST INFORMATION:

Company Requesting Testing: *

Company web site url address: *

Product Name: *

Product Type: *

List Product Type if you selected Other:

Product Version to be Tested: *

Status of Product Version: *

Current Version Generally Available: *

Type of Test Requested: *

TESTING QUALIFICATION INFORMATION:
Please fill out the appropriate section based on testing type selected above.

Remote Testing - Single Product

Company Name of Product to be tested to:

Product to be tested to:

Product Type:

List Product Type if you selected Other:

Version(s):

Length of testing time requested:

in number of consecutive days

Requested Start Date:

We will do our best to accommodate
your timing request so please provide
a range of times if possibe

Requested End Date:

Special Needs
(such as support during
Non-Standard Support Hours):

Product Certification

Company Name of Product to be tested to:

Product to be tested to:

Product Type:

List Product Type if you selected Other:

Version(s):

Requested Start Date:

Requested End Date:

Special Needs:

Solution Certification - Program Director will call you to discuss

Describe products in solution to be tested:

Product Assessment

Company Name of Product to be tested to:

Product to be tested to:

Product Type:

List Product Type if you selected Other:

Version(s):

Requested Start Date:

Requested End Date:

Special Needs:

Additional Comments

TESTING POINT OF CONTACT:

Name: *

Title: *

Office Number: *

Cell Number:

Fax Number:

Pager:

Email: *

Preferred Contact Method: *

* - Required fields