5933 Bellaire Blvd., Suite 108 Houston, TX 77081 Tel: 713-661-1884 Fax: 713-661-0625 npsinc@flash.net

Thin Section Order Form

Bill To:

Name:    ________________________________________________________________________

Company: ________________________________________________________________________

Address: ________________________________________________________________________

City:    ________________________________________________________________________

Province/State:_________________________________________  Zip: __________________

Phone:   ________________________________  Fax: _________________________________

Email:   ________________________________________________________________________

Credit Card #  __________________________________   Exp. Date:   ________________

3 Digit Security Code (back of card) _____   Name on Card:   ____________________

Thin Sections

Size of Section:  ____________________________       Cover Slip:   Yes      No

Impregnation:  Blue    Clear    Fluorescent :Yellow  Pink         No Impregnation

Polishing:     Polish     Micro Probe Polish     No Polish

Staining:      Calcite (ARS)    Iron Rich Carbonate (ARS & Potassium Ferricyanide)
               Potassium Feldspar         Plagioclase           No Staining

Ground in Oil: Yes   No       Orientation: Yes   No


Turnaround Time

Drilling Well (24 hours)  Super Rush (2-5 Days)   Rush (10 Days)  Regular (4 Weeks)


Engraving Information:

1.  ________________________  11. _______________________  21. ____________________

2.  ________________________  12. _______________________  22. ____________________

3.  ________________________  13. _______________________  23. ____________________

4.  ________________________  14. _______________________  24. ____________________

5.  ________________________  15. _______________________  25. ____________________

6.  ________________________  16. _______________________  26. ____________________

7.  ________________________  17. _______________________  27. ____________________

8.  ________________________  18. _______________________  28. ____________________

9.  ________________________  19. _______________________  29. ____________________

10. ________________________  20. _______________________  30. ____________________

Billing: National Petrographic Service accepts Visa, Mastercard, American Express or Check. If a P.O. # is necessary for processing payment with your organization, please include the P.O. # when available. Otherwise, an invoice will follow the shipped work within 5 working days and will be addressed to the "Bill To" recipient.