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Purchase Order Request Form

To order by credit card, please select the product you would like to purchase, add the item(s) to your shopping cart, and proceed to check-out.

For large companies and government institutions that can not pay by credit card, please complete the following Purchase Order Request Form  (*) Required Fields

This form is a request for purchase order - upon completion, we will email you our address, fax number, company information, terms and conditions of sale, method for determining shipping, and W9 form upon request. This will allow you to complete and fax your purchase order.

Only institutions originating in the United States can submit a Purchase Order.

Purchase Orders must be greater than $200.

Limitations and Exemptions:
  • We only accept purchase orders (30 Day Terms) from schools, government agencies, hospitals, and large established companies.
  • The Davis Instruments Sale Price (marked in red on the product page) is valid for online credit card purchases only.
If you do not have a purchase order number at this time, enter "N/A". If your business or school does not have a DUNS number, enter "N/A".

If you are a reseller, please fill out the form for Volume Discounts.

Your Name*:  
Contact Email*:  
Shipping Address*:  
Street Address
City, State and Zip
Name or Institution*:  
Fax Number:  
DUNS Number:  
List the following:  
Catalog Number
Quantity and Price


1. If you cannot fill out this form, please send all information indicated to:

2. Note - special low Davis Pricing and Price Match offers are not eligible for Purchase Orders.