AOAC RESEARCH INSTITUTE CONSULTING SERVICE - TESTING PROTOCOL DEVELOPMENT

APPLICATION FOR RESEARCH INSTITUTE PROTOCOL DEVELOPMENT
PART I - AUTHORIZED METHOD SUBMITTER

CONTACT INFORMATION
Please note that this application must be completed and submitted by the contact that is authorized by the organization to pursue and obtain validations and/or development of protocols. All correspondence in relation to this application will be directed to the contact listed in this section.

FORM NOT APPLICABLE FOR OMA
First Name*
Last Name*
Organization*
Title*
AOACRI Account ID#:
Address*
Include City/Town, State/Country & Postal Code*
Email Address*
Telephone*
LEGAL NAME OF METHOD and PTM number (if applicable):*
Date Submitted

MonthDayYear
Date

PART I.A. - FINANCIAL CONTACT INFORMATION
Please provide the contact information for the person within your organization that will be responsible for receiving and processing the payments for invoicing.
Financial Contact: First Name*
Financial Contact: Last Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number:

PART II - TERMS & CONDITIONS
Please read all of the AOAC INTERNATIONAL Terms and Conditions ( certain items are subject to change ). Consulting Services (Validation Protocol Development & Review) AOAC INTERNATIONAL Policy Documents Use of Association Name Anti-Trust Volunteer Conflict of Interest I have read and agree to the terms and conditions.*

AcceptDecline
AOAC Research Institute Fee Schedule

AOAC Terms and Conditions 2023v1

All documents uploaded with the application will be handled as confidential according to the PTM Programs Policies and Procedures.

PART IV- METHOD INFORMATION
LEGAL METHOD NAME:*
Catalog Number(s) - (if applicable)
PTM Certification/OMA # (if applicable)
Method Applicability and Intended Use*
Matrices to be reviewed:*
IF this is for Modification, give a brief description of proposed Modification/Extension:
Are you currently working with an AOACRI Technical Consultant?*

Sharon BrunelleMaria NelsonZerlinde JohnsonKaren SilbernagelCheryl LassiterDawn DowellDon GillilandNo technical consultant has been assigned
UPLOAD ATTACHMENTS*
**Attach Supporting Documents: REQUIRED For PTM; PACKAGE INSERT(s), USER GUIDE/INSTRUCTIONS, PREP MANUAL/SOFTWARE MANUAL, GMP-QA/QC SYNOPSIS. Additional documents; Draft protocols, method safety information, etc... (multiple files allowed and file size limit is 20 MB)*

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