Pre-Registration

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Pre-Registration:

Pre-registration allows you to indicate your interest in a particular proficiency test package and send us the information necessary to start the registration process.

Fields in red are required.

Test Package:
Week(Monday):		The package you selected is already booked for the week of 8/9/2010
Laboratory Name:
Laboratory Contact:
Address 1:
Address 2:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Comments:

The "Submit" button sends the data to us.

The "Reset" button removes your changes to the form.

The "Start Over" button gives you a fresh, clean form.

When we receive your pre-registration, we will contact you to let you know if the package is still available for the week you have requested, instruct you on what forms you need to fill out and send to us (e.g. confidentiality agreement) and take your payment information.

We must have a signed confidentiality agreement before we can arrange to have the package shipped to you. If you have participated in a proficiency test with us before, you do not need to re-submit a confidentiality agreement.

Payment is due a week after registration, or 2 weeks before your proficiency test week starts, whichever is earliest.

HN Proficiency Testing now accepts the following credit cards:

Please understand that this is NOT a secure site. However, you can enter your credit card information in the comment field (Card Type, Card Number, Expiration Date, Name on Card and Address of Cardholder). Alternatively you can fax us the information at (866) 792 2286 or put a note in the comment field, if you want us to contact you to get the card information.

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