EH&S Home

Chemical Shipping Request Form

Please complete the form below to make a request for chemical shipment.Please allow us two business days to start your request.

Please contact Krista Hyde at (314) 362-6866 for further inquiry.
CONTACT INFORMATION
Full Name:
Please enter your name
Phone Number:
Email:
Please enter your e-mail
PI Full Name:
Please enter PI's Full Name
Lab Location Campus:
Please select lab location

Building:
Please enter lab building name

Room#:  
Please enter lab room number
Lab Mailing Address
Campus Box#:
Please enter a campus box number

City:   
Please enter lab City

State:
Zip:    
Please enter lab zip
CHEMICAL/PACKAGE INFORMATION
Chemical Description:
Quantity:
Please enter Chemical Quantity
Volume/Size
Quantity Per container/package:
Container/package Type: (Example:3 x 50 mL conical tubes)
Require dry Ice: Yes    No
Note:
SHIPPING INFORMATION
Receiver/Business Name:
Please enter Receiver/Business Name
Address line 1:
Please enter Receiver Address
Address line 2:
City:
Please enter Receiver City
State:
Province:
Zip:
Please enter Receiver zip
Country:
Phone: