7 MBL Street, Woods Hole, MA 02543 USA | p: 508.289.7430 | email@example.com | www.mbl.edu/education
Special Request Form for Shipping Course Orders to Home Institutions
1. Prior to placing your order, complete this form and return it to firstname.lastname@example.org
for approval. Orders will not be placed without this authorization.
Item/Catalog Number Vendor Quantity Estimated Cost
Reason for shipping to home institution, not MBL and date needed:
2. Upon receipt of order: Send scanned copy of signed packing slip including date of
receipt to email@example.com. Your signature affirms receipt of intact item(s). All
items must be shipped or brought to the course at MBL.
I hereby agree to the conditions described on this form and attest to the truthfulness of the
rationale for not shipping these items to MBL.
Signature of Investigator
Approved by Director of Education