Please complete the form below for your 2023 calibrations.YCG Payment PolicyIf you have any questions or issues completing the form, please call (570) 494-1150 ext. 0 for assistance. Thank you! PA Calibration Agreement Step 1 of 6 16% Contact InfoProvide your department information, contact regarding the calibrations, and billing information.Police Department Name(Required) Police Department Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Police Department Phone Number(Required)Do you have a Fax Number?(Required) Yes No Police Department Fax Number(Required)Primary Speed-Timing Contact Name(Required) First Last Primary Speed-Timing Contact Title/Rank Primary Contact Cell/Work Number(Required)Primary Contact Email(Required) Enter Email Confirm Email Is there an alternate speed-timing contact?(Required) Yes No Secondary Speed-Timing Contact Name(Required) First Last Secondary Speed-Timing Contact Title/Rank Secondary Contact Cell/Work Number(Required)Secondary Contact Email(Required) Enter Email Confirm Email BillingPlease note that invoices are sent via email. See YCG Payment Policy for more details.Billing Contact Name(Required) First Last Billing Phone Number(Required)Billing Email(Required) Enter Email Confirm Email Is the Billing Address the same as above?(Required) Yes No Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Calibration Location InfoLet us know where we will see you for your calibrations.Will we be stopping at your station?(Required) Come to my location Meet at another location We'll come to YCG facility We'll mail to YCG facility Is there info we should know regarding the location?(Required) Yes No Additional Info Regarding Your Location, the Meeting Location, or cals at YCG Payment InfoHow would you like to be invoiced?Payment Type(Required)Please choose how you would like to pay for your calibrations. NOTE: Mail-in equipment is invoiced prior to equipment return. Prepay | You're invoiced once for the year Pay-Per-Cal | You're invoiced after each visit for calibrations & On-Site Fees (as applicable) On-Site Fee | Prepay Option(Required)Would you like to save $150? We will invoice you on 01/01/23 or sooner if needed and as long as payment is received by 01/31/23, you will save $150! If payment is not received by 01/31/23 the invoice will be voided and you will be reinvoiced at the regular cost. Yes, invoice me early to save $150 No thanks, invoice me with my calibrations No thanks, invoice me after each visit Payment Policy Acknowledgement(Required) I have reviewed and agree to the payment policy. Equipment InfoYour department received the current equipment list that we have on record. Please use this as a reference to answer the question(s) below.Will your equipment remain the same?(Required) Yes, the list you provided is correct No, the changes are listed below Equipment ChangesEquipment Changes UploadYou may upload the corrected equipment list.Accepted file types: jpg, png, pdf, Max. file size: 32 MB.Is there any other information we need regarding your calibrations?(Required) Yes No Additional Info AcknowledgementConsent(Required)I am authorized by my organization to submit this agreement. I confirm the information provided above is accurate to the best of my knowledge. YesAuthorized Representative(Required) First Last Date(Required) MM slash DD slash YYYY CAPTCHA
