If you are having trouble submitting this form please contact us for an alternative format. Current Start Details of samples Complete Sample size Note: samples must be at least one metre by one metre in size. Contact the testing service if your samples do not meet this requirement. Company name Company address (street address, city/town, state/province, postcode, country) Contact name Email address Phone I hereby authorise the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) to conduct testing of the samples described below. I have read and agree to abide by the Terms & Conditions for Service and Conditions for Test Samples. I agree Leave this field blank