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1. Sample description

Sample name*
Date of collection
Material of sample*
Additional information about material of sample
(botanical or lithological identification, species etc.)
Contamination*
Expected age / period / phase
Depth below surface (m)

2. Sample location

Country*
Province/district, town, region*
Geographical coordinates vs. Greenwich
Lat (N/S)
e.g. 33o33'=33o33'N ; -33o33'=33o33'S
o  '
Long (E/W)
e.g. 133o33'=133o33'E ; -133o33'=133o33'W
o  '
Altitude (m a. s. l)
Short geographical description
of the environment of site
(the nearest lake, mountain etc.)*
Field of study*
Significance of problem to be solved by date*
Other existing dates of this site, layer, object (lab. code and age)
References to literature (please provide reprints if available)
Short description of the geomorphological
and stratigraphical context of sample,
details about position of sample within site
Type of site*

3. Submitter/buyer

SubmitterBuyer
Name*
Institution*
Office/branch
Address*
City*
Zip code*
Country*
E-mail*
Telephone
Fax
NIP / EU VAT
NIP / EU VAT = TVA intracommunautaire - for buyers from the EU countries only

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