Dilucup Demonstration Request Form

Name:
First Last
Company:*
Title:*
Date:*
MM slash DD slash YYYY
DEMONSTRATION UNIT REQUESTED
Catalog No.:
Preference #1:
Preference #2:
Accessories:
Diluent (choose one):*
- MRD
- BPW
- NACL
- BFD
Shipping Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred Demo Start Date:*
MM slash DD slash YYYY
Preferred Demo End Date*
MM slash DD slash YYYY
Demo Contact Name:*
First Last
Phone:*
Email:*

Upon submission, a copy of this form will be emailed to the address provided.
Terms & Conditions*
- By checking this box, you are confirming that you have read, understood, and agree to our Terms & Conditions

In closing I would like to pass along that since my first contact with Hardy Diagnostics mid last year, the services provided have been second to none. Hardy has been a great addition to my list of suppliers. Whether it be a friendly customer service rep that I speak to when calling in an order, talking with Cindy, or having the pleasure to work with someone such as yourself. I would like the thank you Cindy, and the ENTIRE Hardy team for always leaving me with a warm and fuzzy feeling no matter what the reason is for contacting. You guys are AWESOME!!!

Corey A. Foster
Quality Control Laboratory Technician

Dilucup Demonstration Request Form

DEMONSTRATION UNIT REQUESTED

The HardyBlog

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Dilucup Demonstration Request Form

DEMONSTRATION UNIT REQUESTED

The HardyBlog

MicroBytes Newsletter

News and Events