Physics & Astronomy Shipping Form

Rutgers Department of Physics & Astronomy

Instructions: Please completely fill out this form (including signature) and leave the package in the stockroom for carrier pick-up.

You can

Print this form, fill it out, and leave it with the package
Fill out this form and press SUBMIT to send to stockroom (signed later on paper)

Please note: when printing this form out, checked/selected checkboxes and radio buttons will print as shown on the screen.

Billing Information

Date

Group/Faculty Member

Requester's First & Last Name

Account to be Charged

Signature of Group/Faculty Member in charge of Account

Package Information

Destination:	Receiver's Name: Company Name: Address Line 1: Address Line 2: City, State, Zip Code: Country:
Item being shipped
Purpose of shipment	Research Material Other(describe):
Approximate Weight	lbs.
Insurance	Yes No
Hazardous	Yes No - If Yes, REHS Notified date

Carrier Information

Carrier:	FedEx-Ground FedEx-Express FedEx-Freight UPS Other
Service Type:
Saturday Delivery (if needed):
Other Services (if any additional info please attach declaration, bill of lading, quotes, etc.):

Please bring the completed form to:
Physics & Astronomy Stockroom, Rm 134, 136 Frelinghuysen Rd, Piscataway, NJ 08854

Problems with this web form should be directed to doroshenko@physics.rutgers.edu
Issues concerning package shipping or billing should be directed to jlarsen@physics.rutgers.edu