AOAC PERFORMANCE TESTED METHODS (PTM)

APPLICATION FOR METHOD REVISIONSfor Proprietary and Sole Source Methods

NOT FOR RENEWAL MODIFICATIONS
PART I - AUTHORIZED METHOD SUBMITTER

CONTACT INFORMATION

Please note that this application must be completed and submitted by the contact that is authorized by the organization to pursue and obtain validation and/or the development of protocols. All correspondence in relation to this application will be directed to the contact listed in this section.
First Name*
Last Name*
Organization*
Title*
Address*
Include City/Town, State/Country & Postal Code*
Email Address*
Telephone*
Legal Name of Method and PTM number:*

PART I.A. - FINANCIAL CONTACT INFORMATION

Please provide the contact information for the person within your organization that will be responsible for recieving and processing the payments for invoicing.
Financial Contact: First Name*
Financial Contact: Last Name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone*
E-mail

PART II - TERMS & CONDITIONS

Please read all Terms and Conditions. (Certain items are subject to change).
AOAC INTERNATIONAL Policy Documents Use of Association Name Anti-Trust AOAC Volunteer Conflict of Interest
AOAC Research Institute Fee Schedule
AOAC Research Institute Fee Schedule
NOTE: All modifications are subject to detailed review to assess correct level of modification/extension. Identical modifications for Levels 1 & 2 must be submitted at the same time on the same application and will be reviewed to assure full requirements are met prior to granting discount.
*I have read and agree to the terms and conditions.

AcceptDecline

PART III - METHOD REVIEW
Did you have Consulting?

I have submitted for ConsultingYes - I had ConsultingNo - I don't need Consulting
Please select the appropriate method review program:*

AOAC Performance Tested (PTM) - ModificationAOAC Performance Tested (PTM) & AOAC Offical Methods (OMA)
Is your method being submitted to participate in an ERV or Targeted Matrix Extension (TME)?

YES - ERVYES - TMENO to both
* OMA modifications will require a seperate OMA modification application. Contact Deborah McKenzie ( DMckenzie@aoac.org) for further information.

PART VII - AUTHORIZATIONS FOR SUBMISSION
Is this method recognized or adopted by another organization or agency outside of AOAC?*

YESNO
Please list the name(s) of the organization(s) or agency(ies).*
Does the organization(s) or agency(ies) support the proposed modification being submitted to AOAC?*

YESNO
Please provide the name and contact information (including email ) for the primary or secondary representative at the organization(s) or agency(ies) as it relates to this method.*
Please describe why the organization(s) or agency(ies) listed in this section does (do) not support the proposed modification.*
* NOTE: For modifications pertaining to OMA methods, a modification application will be required with the AOAC Official Methods Program. Please contact Deborah McKenzie (DMckenzie@aoac.org) for further information.
Date Submitted*

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Date