Qualified Test Equipment Certification Application Form

Product Price*
Total
$14,000.00
Payment Method*
- Send me an Invoice
- Credit Card Payment
BILLING ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Credit Card*
Card Details
Cardholder Name
BY SUBMITTING THIS REQUEST FOR DESIGNATED AS QUALIFIED TEST EQUIPMENT, THE TEST EQUIPMENT PROVIDER AGREES TO PAY ALL APPLICABLE QUALIFIED EQUIPMENT FEES FOR THE TEST EQUIPMENT IDENTIFIED ABOVE. THIS REQUEST WILL NOT BE PROCESSED UNTIL THE QUALIFIED EQUIPMENT FEES ARE PAID IN FULL. THESE QUALIFIED EQUIPMENT FEES ARE NON-REFUNDABLE.
Terms of Service*
I am authorized to submit this application on behalf of the Applicant and hereby certify that the answers provided are true and complete to the best of my knowledge and understanding.
- I agree to the Terms of Service