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Create New Waypoint Account

Type of Client

Agricultural

Environmental

Other

Home Owners/Landscapers

Lab

Lab ID

Lab Name

Lab City

Lab State

00001	Waypoint Analytical, LLC. (Memphis)	Memphis	TN
00002	Waypoint Analytical Iowa, Inc.	Atlantic	IA
00006	Waypoint Analytical California, Inc.	Anaheim	CA
00008	Waypoint Analytical Carolina, Inc.	Wilson	NC
00009	Waypoint Analytical Virginia, Inc.	Richmond	VA
00010	Waypoint Analytical Florida, Inc.	Lakeland	FL
00011	Waypoint Analytical Illinois, Inc.	Champaign	IL
00012	Waypoint Analytical Pennsylvania, Inc.	Leola	PA
00017	Waypoint Analytical Carolina, Inc. (Greenville)	Greenville	NC
00018	Waypoint Analytical, LLC. (Grand Island)	Grand Island	NE

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User ID (email address for account)

Name

Company Name (Leave blank for individuals)

Billing Info Same as Shipping

Shipping Info

Contact

Address

City

State

Abbreviation

Alabama	AL
Alaska	AK
Alberta	AB
Arizona	AZ
Arkansas	AR
British Columbia	BC
California	CA
Colorado	CO
Connecticut	CT
Delaware	DE
District of Columbia	DC
Florida	FL
Georgia	GA
Hawaii	HI
Idaho	ID
Illinois	IL
Indiana	IN
Iowa	IA
Jalisco	Jlco
Kansas	KS
Kentucky	KY
Louisiana	LA
Maine	ME
Manitoba	MB
Maryland	MD
Massachusetts	MA
Michigan	MI
Minnesota	MN
Mississippi	MS
Missouri	MO
Montana	MT
Nebraska	NE
Nevada	NV
New Brunswick	NB
New Hampshire	NH
New Jersey	NJ
New Mexico	NM
New York	NY
Newfoundland and Labrador	NL
North Carolina	NC
North Dakota	ND
Northwest Territories	NT
Nova Scotia	NS
Nunavut	NU
Ohio	OH
Oklahoma	OK
Ontario	ON
Oregon	OR
Pennsylvania	PA
Prince Edward Island	PE
Puerto Rico	PR
Quebec	QC
Rhode Island	RI
Saskatchewan	SK
South Carolina	SC
South Dakota	SD
Tennessee	TN
Texas	TX
US Virgin Islands	VI
Utah	UT
Vermont	VT
Virginia	VA
Washington	WA
West Virginia	WV
Wisconsin	WI
Wyoming	WY
Yukon	YT

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Zip

Phone

Fax

Billing Info

Contact

Address

City

State

Abbreviation

Alabama	AL
Alaska	AK
Alberta	AB
Arizona	AZ
Arkansas	AR
British Columbia	BC
California	CA
Colorado	CO
Connecticut	CT
Delaware	DE
District of Columbia	DC
Florida	FL
Georgia	GA
Hawaii	HI
Idaho	ID
Illinois	IL
Indiana	IN
Iowa	IA
Jalisco	Jlco
Kansas	KS
Kentucky	KY
Louisiana	LA
Maine	ME
Manitoba	MB
Maryland	MD
Massachusetts	MA
Michigan	MI
Minnesota	MN
Mississippi	MS
Missouri	MO
Montana	MT
Nebraska	NE
Nevada	NV
New Brunswick	NB
New Hampshire	NH
New Jersey	NJ
New Mexico	NM
New York	NY
Newfoundland and Labrador	NL
North Carolina	NC
North Dakota	ND
Northwest Territories	NT
Nova Scotia	NS
Nunavut	NU
Ohio	OH
Oklahoma	OK
Ontario	ON
Oregon	OR
Pennsylvania	PA
Prince Edward Island	PE
Puerto Rico	PR
Quebec	QC
Rhode Island	RI
Saskatchewan	SK
South Carolina	SC
South Dakota	SD
Tennessee	TN
Texas	TX
US Virgin Islands	VI
Utah	UT
Vermont	VT
Virginia	VA
Washington	WA
West Virginia	WV
Wisconsin	WI
Wyoming	WY
Yukon	YT

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Zip

Phone

Fax

Email address for Electronic Delivery

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Export Type Name

Export Type Description

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Email Address

Export Type

Comments

Soil Report Type (If none is selected Client Services will choose the appropriate type) View Examples

Type

Description

Example

SC5GW

Graphical English (1 sample per page)

CCM3

CCM3 M3ppm style

BIGTIN

BIGTIN style

A17

Report A17 - Soil Multi Basic

BALS

Soil Data Composite Sheet

Page 1 of 7 (34 items)[1]2 3 4 5 6 7

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Plant Report Type (If none is selected Client Services will choose the appropriate type) View Examples

Type

Description

Example

MPTSR

Mutli sample PT report w/ shaded rating

MULTPT

PT MULTI SAMPLE REPORT

PLANT TISSUE REPORT Portrait

PTTRN2

Plant Tissue Trending Report

PTL

PLANT TISSUE REPORT Landscape

Page 1 of 2 (6 items)[1]2

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Client Account Creation Authorization Form (Click + button to fill out form)

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User ID (email address on account)

Name

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Portal Sign In

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Client Account Creation Authorization Form

Complete Legal Name

Phone

Fax

Ship to Address (Not P.O. Box)

City

State

Zip

State

Abbreviation

Alabama	AL
Alaska	AK
Alberta	AB
Arizona	AZ
Arkansas	AR
British Columbia	BC
California	CA
Colorado	CO
Connecticut	CT
Delaware	DE
District of Columbia	DC
Florida	FL
Georgia	GA
Hawaii	HI
Idaho	ID
Illinois	IL
Indiana	IN
Iowa	IA
Jalisco	Jlco
Kansas	KS
Kentucky	KY
Louisiana	LA
Maine	ME
Manitoba	MB
Maryland	MD
Massachusetts	MA
Michigan	MI
Minnesota	MN
Mississippi	MS
Missouri	MO
Montana	MT
Nebraska	NE
Nevada	NV
New Brunswick	NB
New Hampshire	NH
New Jersey	NJ
New Mexico	NM
New York	NY
Newfoundland and Labrador	NL
North Carolina	NC
North Dakota	ND
Northwest Territories	NT
Nova Scotia	NS
Nunavut	NU
Ohio	OH
Oklahoma	OK
Ontario	ON
Oregon	OR
Pennsylvania	PA
Prince Edward Island	PE
Puerto Rico	PR
Quebec	QC
Rhode Island	RI
Saskatchewan	SK
South Carolina	SC
South Dakota	SD
Tennessee	TN
Texas	TX
US Virgin Islands	VI
Utah	UT
Vermont	VT
Virginia	VA
Washington	WA
West Virginia	WV
Wisconsin	WI
Wyoming	WY
Yukon	YT

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Billing Address (if different)

City

State

Zip

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State

Abbreviation

Alabama	AL
Alaska	AK
Alberta	AB
Arizona	AZ
Arkansas	AR
British Columbia	BC
California	CA
Colorado	CO
Connecticut	CT
Delaware	DE
District of Columbia	DC
Florida	FL
Georgia	GA
Hawaii	HI
Idaho	ID
Illinois	IL
Indiana	IN
Iowa	IA
Jalisco	Jlco
Kansas	KS
Kentucky	KY
Louisiana	LA
Maine	ME
Manitoba	MB
Maryland	MD
Massachusetts	MA
Michigan	MI
Minnesota	MN
Mississippi	MS
Missouri	MO
Montana	MT
Nebraska	NE
Nevada	NV
New Brunswick	NB
New Hampshire	NH
New Jersey	NJ
New Mexico	NM
New York	NY
Newfoundland and Labrador	NL
North Carolina	NC
North Dakota	ND
Northwest Territories	NT
Nova Scotia	NS
Nunavut	NU
Ohio	OH
Oklahoma	OK
Ontario	ON
Oregon	OR
Pennsylvania	PA
Prince Edward Island	PE
Puerto Rico	PR
Quebec	QC
Rhode Island	RI
Saskatchewan	SK
South Carolina	SC
South Dakota	SD
Tennessee	TN
Texas	TX
US Virgin Islands	VI
Utah	UT
Vermont	VT
Virginia	VA
Washington	WA
West Virginia	WV
Wisconsin	WI
Wyoming	WY
Yukon	YT

Billing Contact Email

Billing Contact Phone

Billing Contact Fax

Type of Company

Federal Tax Number

Number of Employees

Sole Proprietor

Partnership

Corporation

LLC

State/Date of Incorporation

Publicly Traded

Years in Present Business

Type of Business

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State

Abbreviation

Alabama	AL
Alaska	AK
Alberta	AB
Arizona	AZ
Arkansas	AR
British Columbia	BC
California	CA
Colorado	CO
Connecticut	CT
Delaware	DE
District of Columbia	DC
Florida	FL
Georgia	GA
Hawaii	HI
Idaho	ID
Illinois	IL
Indiana	IN
Iowa	IA
Jalisco	Jlco
Kansas	KS
Kentucky	KY
Louisiana	LA
Maine	ME
Manitoba	MB
Maryland	MD
Massachusetts	MA
Michigan	MI
Minnesota	MN
Mississippi	MS
Missouri	MO
Montana	MT
Nebraska	NE
Nevada	NV
New Brunswick	NB
New Hampshire	NH
New Jersey	NJ
New Mexico	NM
New York	NY
Newfoundland and Labrador	NL
North Carolina	NC
North Dakota	ND
Northwest Territories	NT
Nova Scotia	NS
Nunavut	NU
Ohio	OH
Oklahoma	OK
Ontario	ON
Oregon	OR
Pennsylvania	PA
Prince Edward Island	PE
Puerto Rico	PR
Quebec	QC
Rhode Island	RI
Saskatchewan	SK
South Carolina	SC
South Dakota	SD
Tennessee	TN
Texas	TX
US Virgin Islands	VI
Utah	UT
Vermont	VT
Virginia	VA
Washington	WA
West Virginia	WV
Wisconsin	WI
Wyoming	WY
Yukon	YT

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April 2025

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Years at Location

Own

Rent

Name of Owner, Partner and/or Officers responsible for business transactions

Title

SS #

Name of Bank

Contact Person

Phone

Fax

Checking Account No

Loan Account No

Trade References

Company

Contact

Phone

Fax

Amount of credit requested

Estimated annual $ volume planned next 12 months

Frequency of samples to be processed

Annually

Monthly

Quarterly

Entire Agreement: This agreement constitutes the entire agreement between all divisions/subsidiaries of
Waypoint Analytical, Inc. for the services to be performed, and supersedes all prior representations and agreements, whether written or oral.

As part of this customer information, permission is hereby granted to access a consumer/commercial credit report, and to contact
any and all of the trade and bank references listed above, together with any other references which may be provided by these trade and bank references. All pricing and service
disputes must be made in writing within 15 days of receipt of invoice. Claims not received within 30 days from receipt of invoice may be refused.

Payment: Payment for services is due within thirty (30) days from the original date of invoice unless otherwise stated herein.
Client promises to pay promptly all such payments.

By signature hereon, the applicant acknowledges having read and understands this application for credit in its entirety and the terms
and conditions relating hereto; and understands and agrees that Waypoint Analytical, Inc. may act in reliance upon the information specified herein; and that the information contained
herein is true and correct to the best of the applicant’s knowledge and belief.

Authorized signature (owner, officer, partner)

Title

Printed Name

Date

April 2025

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17	20	21	22	23	24	25	26
18	27	28	29	30	1	2	3
19	4	5	6	7	8	9	10

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AT&T

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Consumer Cellular

Cricket

Google Fi

Metro PCS

Page Plus

Republic Wireless

Sprint

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Ting

Tracfone

U.S. Cellular

Verizon

Virgin Mobile

XFinity Mobile

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