Submission Form

Date Submitted

Organization Name

Account Manager/Referred By

Total Number of Samples Submitting

Submission Page Number (1/2 - If submitting more than 5 samples)

Sample 1 - Sample Name

Sample 1 - Strain Name (If same as above leave blank)

Sample 1 - Estimated Sample Weight Total (grams, ozs, mls, pieces submitting)

Sample 1 - Category (Plant, Concentrate, Ingestible, Topical)

Sample 1 - Type (Cured, Trim, RSO, Wax, Gummy, Salve, ect)

Sample 1 - Classification (Sativa, Indica, Hybrid, CBD, etc)

Sample 1 - Production Method (In/Outdoor, GH, Co2, Infused, Ing, etc)

Sample 1 - Batch ID

Sample 1 - Batch Size/Weight

Sample 1 - Lot ID

Sample 1 - Lot Size

Sample 1 - Amount Per Serving Total (mgs per Serving)

Sample 1 - Servings per Container (Total mgs per Container)

Sample 1 - Material Description (Candy, Chocolate, Liquid, Oil, etc)

Sample 1 - Container Description (Vac Sealed, Jar, Glass Dropper, Spray Bottle)

Sample 1 - Test Requested (FSP, Mini Pkg, Pot, Terps, etc)

Sample 1 -Other Info & Notes

Sample 2 - Sample Name

Sample 2 - Strain Name (If same as above leave blank)

Sample 2 - Estimated Sample Weight Total (grams, ozs, mls, pieces submitting)

Sample 2 - Category (Plant, Concentrate, Ingestible, Topical)

Sample 2 - Type (Cured, Trim, RSO, Wax, Gummy, Salve, ect)

Sample 2 - Classification (Sativa, Indica, Hybrid, CBD, etc)

Sample 2 - Production Method (In/Outdoor, GH, Co2, Infused, Ing, etc)

Sample 2 - Batch ID

Sample 2 - Batch Size/Weight

Sample 2 - Lot ID

Sample 2 - Lot Size

Sample 2 - Amount Per Serving Total (mgs per Serving)

Sample 2 - Servings per Container (Total mgs per Container)

Sample 2 - Material Description (Candy, Chocolate, Liquid, Oil, etc)

Sample 2 - Container Description (Vac Sealed, Jar, Glass Dropper, Spray Bottle)

Sample 2 - Test Requested (FSP, Mini Pkg, Pot, Terps, etc)

Sample 2 - Other Info & Notes

Sample 3 - Sample Name

Sample 3 - Strain Name (If same as above leave blank)

Sample 3 - Estimated Sample Weight Total (grams, ozs, mls, pieces submitting)

Sample 3 - Category (Plant, Concentrate, Ingestible, Topical)

Sample 3 - Type (Cured, Trim, RSO, Wax, Gummy, Salve, ect)

Sample 3 - Classification (Sativa, Indica, Hybrid, CBD, etc)

Sample 3 - Production Method (In/Outdoor, GH, Co2, Infused, Ing, etc)

Sample 3 - Batch ID

Sample 3 - Batch Size/Weight

Sample 3 - Lot ID

Sample 3 - Lot Size

Sample 3 - Amount Per Serving Total (mgs per Serving)

Sample 3 - Servings per Container (Total mgs per Container)

Sample 3 - Material Description (Candy, Chocolate, Liquid, Oil, etc)

Sample 3 - Container Description (Vac Sealed, Jar, Glass Dropper, Spray Bottle)

Sample 3 - Test Requested (FSP, Mini Pkg, Pot, Terps, etc)

Sample 3 - Other Info & Notes

Sample 4 - Sample Name

Sample 4 - Strain Name (If same as above leave blank)

Sample 4 - Estimated Sample Weight Total (grams, ozs, mls, pieces submitting)

Sample 4 - Category (Plant, Concentrate, Ingestible, Topical)

Sample 4 - Type (Cured, Trim, RSO, Wax, Gummy, Salve, ect)

Sample 4 - Classification (Sativa, Indica, Hybrid, CBD, etc)

Sample 4 - Production Method (In/Outdoor, GH, Co2, Infused, Ing, etc)

Sample 4 - Batch ID

Sample 4 - Batch Size/Weight

Sample 4 - Lot ID

Sample 4 - Lot Size

Sample 4 - Amount Per Serving Total (mgs per Serving)

Sample 4 - Servings per Container (Total mgs per Container)

Sample 4 - Material Description (Candy, Chocolate, Liquid, Oil, etc)

Sample 4 - Container Description (Vac Sealed, Jar, Glass Dropper, Spray Bottle)

Sample 4 - Test Requested (FSP, Mini Pkg, Pot, Terps, etc)

Sample 4 - Other Info & Notes

Sample 5 - Sample Name

Sample 5 - Strain Name (If same as above leave blank)

Sample 5 - Estimated Sample Weight Total (grams, ozs, mls, pieces submitting)

Sample 5 - Category (Plant, Concentrate, Ingestible, Topical)

Sample 5 - Type (Cured, Trim, RSO, Wax, Gummy, Salve, ect)

Sample 5 - Classification (Sativa, Indica, Hybrid, CBD, etc)

Sample 5 - Production Method (In/Outdoor, GH, Co2, Infused, Ing, etc)

Sample 5 - Batch ID

Sample 5 - Batch Size/Weight

Sample 5 - Lot ID

Sample 5 - Lot Size

Sample 5 - Amount Per Serving Total (mgs per Serving)

Sample 5 - Servings per Container (Total mgs per Container)

Sample 5 - Material Description (Candy, Chocolate, Liquid, Oil, etc)

Sample 5 - Container Description (Vac Sealed, Jar, Glass Dropper, Spray Bottle)

Sample 5 - Test Requested (FSP, Mini Pkg, Pot, Terps, etc)

Sample 5 - Other Info & Notes

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