Caen | Nuclear Physics | Product Return Form

Support - Product Return Form

If you would like to view and use this form in PDF format click here.

If requesting to return a product, please complete all information and submit this form. Fields marked with * are required. This will allow us to provide a faster and more efficient service.
After you have inserted the data press the submit button below.

Sender


*Name:**		Company / Institution:

Address:		ZIP/Postal Code:

City:		State/Province:

Country:		Phone:

Fax:		*E-mail:**


Return Shipment to:


If the address is the same as above:

*Name:**		Company / Institution:

Address:		ZIP/Postale Code:

City:		State/Province:

Country:		Phone:

Fax:		E-mail:


Product Description


Product # 1

*Model Name:**		If model is not in the list, insert Model Name:

*Model S. N.:**		*Experiment:**
	( Use only Numeric Characters )	Name of the physics experiment where the product is used. Eventually indicate "Other Uses".

Failure Description*		Repair Location
		CAEN Repair Centeron Customer Site c/o CAEN S.p.A. Via Vetraia, 11 55049 Viareggio (LU) Italy


Product # 2

*Model Name:**		If model is not in the list, insert Model Name:

*Model S. N.:**		*Experiment:**
	( Use only Numeric Characters )	Name of the physics experiment where the product is used. Eventually indicate "Other Uses".

Failure Description*		Repair Location
		CAEN Repair Centeron Customer Site c/o CAEN S.p.A. Via Vetraia, 11 55049 Viareggio (LU) Italy


Product # 3

*Model Name:**		If model is not in the list, insert Model Name:

*Model S. N.:**		*Experiment:**
	( Use only Numeric Characters )	Name of the physics experiment where the product is used. Eventually indicate "Other Uses".

Failure Description*		Repair Location
		CAEN Repair Centeron Customer Site c/o CAEN S.p.A. Via Vetraia, 11 55049 Viareggio (LU) Italy


Product # 4

*Model Name:**		If model is not in the list, insert Model Name:

*Model S. N.:**		*Experiment:**
	( Use only Numeric Characters )	Name of the physics experiment where the product is used. Eventually indicate "Other Uses".

Failure Description*		Repair Location
		CAEN Repair Centeron Customer Site c/o CAEN S.p.A. Via Vetraia, 11 55049 Viareggio (LU) Italy