Chemistry Stores Order Form

Chem Stores receives substantial discounts from most vendors; therefore, final prices will likely be lower than those listed in our vendors' catalogs.

If you have a question about the form, contact Don Wareham, manager of Chem Stores, via email or at 906-487-2049.

Please note: when placing orders with multiple vendors, submit a separate form for each vendor.

* required field

Requestor Name: *
Phone: *
Email: * (
Date Needed:
Delivery Options:   Deliver directly to Chem Stores
+ Chem Stores will handle incoming chemicals according to vendor recommendations and will notify you when the order has arrived.

 Deliver to address
+ Only available from certain vendors

Please enter the delivery information below:

Zip Code:
Qty Unit Catalog # Description Unit Cost Total Cost
  Estimated Total: $
Account: *
Department: *
Date: *
Room # where
used (if chemical): *