Rice University Chemistry Department
Compressed Gas Order Form
First Name:
Your answer
Last Name:
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Email Address:
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Bldg:
Room #:
(Drop-off Point)
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Fund #:
Your answer
Org. #
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Phone #:
Your answer
Type of Gas:
If you cannot find the gas type, provide detailed information in the comments section.
Cyl. Quantity:
Your answer
When Needed?
Your answer
Comments:
Please include the type of gas, purity and cylinder size/volume for any special blends.
Your answer
Submit
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