CHEMISTRY ‐ SAMPLE SUBMISSION FORM Office use only:
Company Name: Halal Certification Authority Pty Ltd
Contact Person: Nadia El-Mouelhy Date:
GPO Box 3906 Print &
Sydney NSW 2001 Email to ALS Time:
Street Address: Condition:
10/2‐8 South St Rydalmere NSW 2116 T: +61 2 8832 7500 | F: +61 2 9898 3472 Opened by: Office use only: Email Address: nadia@halalauthority.org Affix ALS Workorder label Phone: 0401 015 157 or 02 9232 6731 C/ (insert clients full company name) Special Purchase Order No. Instructions:
Sample Name Specific Testing Required Specification
TURNAROUND TIME (Please select one): Normal ✔ URGENT (Prior approval required from ALS and may incur a surcharge) Please state reporting date required:
Please enclose a hard copy of this completed form with the samples