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Sample description

Fields with blue border are required

Sample name

Sample name should be unique.

Date of collection Contamination Expected age / period / phase Depth below surface (m)

Job no. Material of sample Additional information about material of sample (botanical or lithological identification, species etc.)

Sample location

Country

Geographical coordinates vs. Greenwich Lat (N/S)
e.g. 33°33'=33°33'N ; -33° 33'=33°33'S ° '

Altitude (m a. s. l) Short geographical description of the environment of site (the nearest lake, mountain etc.) Significance of problem to be solved by date References to literature (please provide reprints if available) Type of site

Province/district, town, region

Geographical coordinates vs. Greenwich Long (E/W)
e.g. 133°33'=133°33'E ; -133°33'=133°33'W ° '

Field of study Other existing dates of this site, layer, object (lab. code and age) Short description of the geomorphological and stratigraphical context of sample, details about position of sample within site

Submitter/buyer

Submitter

Name Institution Office/branch Address City Zip code Country E-mail Telephone Fax

Buyer

Name Institution Office/branch Address City Zip code Country E-mail NIP / EU VAT = TVA intracommunautaire for buyers from the EU countries only

SAMPLE REGISTRATION FORM SUMMARY

Sample description

Sample name

Date of collection

Material of sample

Additional information about material of sample (botanical or lithological identification, species etc.)

Contamination

Expected age / period / phase

Depth below surface (m)

Sample location

Country

Geographical coordinates vs. Greenwich o '

Altitude (m a. s. l)

Short geographical description of the environment of site (the nearest lake, mountain etc.)

Significance of problem to be solved by date

References to literature (please provide reprints if available)

Type of site

Province/district, town, region

Geographical coordinates vs. Greenwich

Field of study

Other existing dates of this site, layer, object (lab. code and age)

Short description of the geomorphological and stratigraphical context of sample, details about position of sample within site

Submitter

Name

Institution

Office/branch

Address

City

Zip code

Country

E-mail

Telephone

Fax

Buyer

Name

Institution

Office/branch

Address

City

Zip code

Country

E-mail

NIP / EU VAT = TVA intracommunautairefor buyers from the EU countries only