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 Irradiation Request Form
========================

       Company Name    Company Address    Contact Info   Name / Surname    Phone    Email    Type of Product Food Medical Product Raw Material Cosmetic Product Packaging Material Polymer Material Pet Food Test Sample Other              Please Define Other Option    Product Name Lot No Quantity Package Type   Of Cartons / Pcs / Kg Cardboard Box Craft / Gunny Bag Aluminum Box Plastic Drum Other                       Package Dimension Width (cm) Length (cm) Height (cm)        Total Amount Of Product Total Amount Of Cartons  Total Weight (Kg)    Requested Dose Range Min  Max    Has Any Irradiation or Chemical Process Ever Been Applied Before? Yes  No    Ship Non-Irradiated Products to Gammapak Via Vehicle Belongs to Customer  Cargo  Carrier    Please Give Us Your Opinion, Idea or Special Request       I have read the [Data Protection Notice](https://gammapak.com/data-protection-notice) and consent to my personal data being processed for the purposes stated there.

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