Copyright 2008 by LifeConEx:
Company Name
First Name
Telephone Number
Email Address
Address
Postal Code
City
Country
Shipping Information
Billing
Packaging and Equipment Order Form
Last Name
Date Needed by
Remarks
Company Name
First Name
Telephone Number
Email Address
Address
Postal Code
City
Country
Last Name
Remarks
Same as Billing
Transportation will be charged at actual cost (duties and taxes not included). Exact transportation cost can be provided upon request at: Lssc1@lifeconex.com
Order Detail
Item
Quantity
Item
Quantity
Item
Quantity
Item
Quantity
If you are an existing LifeConEx customer and your SOP stipulates that LifeConEx will provide packaging or other equipment such as temperature data loggers, please complete the following form to place your order. We will review the form and confirm your order by email within 24 hours. If you have any questions concerning your order please contact our Life Science Service Center at Lssc1@lifeconex.com.
