DISCOVERY SCIENTIFIC INC.

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Order form

On this side you have the possibility to order online using a simple e-mail. Please complete the order form as detailed as possible. The more precisely you fill out all fields, the quicker and better we can deliver.


Invoice adress
Please fill out all fields
Shipping adress
Please fill out if different from invoice adress

Name:   Name:  
Institute/Company:   Institute/Company:  
Department:   Department:  
Street:   Street:  
City:   City:  
Postal code & State:   Postal code & State:  
Phone no:  
Fax no:  
e-mail:      VAT (value added tax) identification no    
your purchase order no:   (for EEC members only):      

I order following products:
Cat. # Description Pack size Quantity Price Euro

additional details of your order ...
 
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Please note that we can only accept orders which meets our terms & conditions!




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