Enrollment Form - AOAC Cannabis/Hemp Chemistry Proficiency Testing Program

Enrollment Form - AOAC Cannabis/Hemp Chemistry Proficiency Testing Program

**Matrices are dried flower/bud/plant parts** *Prices are per single shipment*
Which of the following programs will you be enrolling in (check all that apply)?

CH01: (Hemp) Cannabinoids, Terpenes, Moisture, Water Activity, Heavy Metals, Pesticide Residues, Mycotoxins - $2,200CH04*: (Cannabis) Cannabinoids, Terpenes, Moisture, Water Activity, Heavy Metals Pesticide Residues, Mycotoxins - $3,100CH02: (Hemp) Cannabinoids, Terpenes, Moisture, Water Activity, Heavy Metals - $1,200CH05*: (Cannabis) Cannabinoids, Terpenes, Moisture, Water Activity, Heavy Metals - $1875CH03: (Hemp) Pesticide Residues & Mycotoxins - $1,000CH06*: (Cannabis) Pesticide Residues & Mycotoxins- $1,225
Please select which of the following rounds you'd like to participate in:

March (Shipping on 3/24/2025)September (Shipping 9/22/2025)Both March & September
*To order CANNABIS (CH04, CH05 and/or CH06) from us, an organization must:

1. Be currently licensed as an Analytical Laboratory and authorized to recieve Schedule I substances.

2. Issue us a physical DEA Form 222 (scans and such are not acceptable for the original order form).

3. Accept the shipment of any controlled samples solely at the address stated on the DEA Form 222 (we *must* ship only to the exact company and address stated on the order form - no exceptions).

4. Not issue the DEA Form 222 until samples are ready to be shipped (order forms expire 60 days after the date the ordering organization states on the original form).
Shipping Information

shipping fees will be determined at the time of enrollment
Person responsible for samples:

First NameLast Name
Name of lab to ship to: (This needs to match the exact name on your DEA Form 222)
Email Address:
example@example.com
Full shipping address samples are being sent to:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number of Person responsible for samples:
Please enter a valid phone number.
Billing Information
Billing Contact for samples: (If same as shipping contact, leave blank)

First NameLast Name
Company Name: (If same as shipping company, leave blank)
Email Address:
example@example.com
Full billing address for payment of samples: (If same as shipping address, leave blank)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number of billing contact: (If same as shipping contact, leave blank)
Please enter a valid phone number.
*Your enrollment date is considered to be the date AOAC recieves this completed jotform. If cancellations are made less than 30 days prior to a shipment date you are responsible for payment of samples reported to the test material provider.*
Should be Empty:

Enrollment Form - AOAC Cannabis/Hemp Chemistry Proficiency Testing Program

Shipping Information

Billing Information