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BT Capillary Online Order Form

1. Select Product to Purchase: Length of  the capillary (meter)
BT1050360 (ID= 50  mm)
BT1075360 (ID= 75  mm)
BT1100360 (ID= 100mm)
BT1200360 (ID= 200mm)


2. Enter Your Shipping Address:
Your Name:
Company Name(optional):
Address Line 1:
Address Line 2 (optional):
City:
State/Province:
(For U.S. address, Please use the two letter state code.)
ZIP/Postal Code:
Country:
Phone:
Email (optional):
3. Enter Your Billing Address: if different than the above
Your Name:
Your Company (optional):
Address Line 1:
Address Line 2 (optional):
City:
State/Province:
ZIP/Postal Code:
Country:


 
Please note: this form only creates a quotation for a BIOTAQ (TM) Product. This quotation will not be treated as an order until payment is received by BIOTAQ INC.

 
 

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Last modified: February 28, 2010, Please fill out Feedback form or Email with questions or comments on this web site. © Copyright 1999-2005  BIOTAQ INC.  All rights reserved.