Data Logger Request Form

Number of Data Loggers

Full cases contain 45 loggers and half cases contain 21 loggers.

Full Cases:

Half Cases:

Date Needed: (enter as mm-dd-yyyy)

Total Number of Loggers Requested:

Requester Information

First Name:

Last Name:

Phone Number: ( ) -

Email Address:

Company:

Address (Line 1):

Address (Line 2): (optional)

City:

State/Province:

Country (if outside US/Canada):

Zip/Postal Code:

Project Notes:

Project Information

Project Name:

Contact at Project Location:

First Name:

Last Name:

Phone Number: ( ) -

Shipping Information

Same As Requester

Company:

Address (Line 1):

Address (Line 2): (optional)

City:

State/Province:

Country (if outside US/Canada):

Zip/Postal Code:

Shipping Contact:

First Name:

Last Name:

Phone Number: ( ) -

Email:

Shipping Method:

UPS Ground

Standard UPS Ground shipping from Sensor Switch, Inc. is included. Shipping by any other method than UPS Ground is at the requester's expense.

Other Shipping Method (requires account number)

Account Number:

Shipping Method:

Terms and Conditions

Sensor Switch Inc. (SSI) will supply data loggers for the above referenced project(s) for a period of 45 days at no charge.  By accepting this contract you agree to return all data loggers, cases, and the included memory "jump" drive within the 45 day period.  Loggers kept over 45 days may be billed at a fee of $200.00 per case per week.  Lost or damaged loggers may also be billed at $250.00 each and failure to return jump drive will incur an additional charge of $95.00.  Standard Sensor Switch payment terms & conditions apply.

I acknowledge and accept these terms and conditions.