Horizon Specialty Product Demo Request Form

PRODUCT DEMO REQUEST

To schedule the demonstration of a Horizon Specialty product, simply complete the following form.
( In most cases a 5-7 day advance notification is sufficient for us to arrange an onsite demo.
If you need a product, or to arrange a demo, sooner than that, please call us ).

Company/Business:

COMPANY NAME:

DIVISION OR DEPARTMENT (If Applicable):

Address/Location:

STREET ADDRESS:

CITY OR TOWN: STATE: ZIP:

TELEPHONE: FAX: E-MAIL:

Choose Product(s) for Demo (You may select one - or
all that are applicable):

Solvent Dispenser
HexSol Bottletop Dispenser UniSol Bottletop Dispenser
High Throughput Cocktail Dispenser 96-Channel Bottletop Dispenser

Multi-Channel Manifold
8-Channel 12-Channel 96-Channel

Solid-Phase Extraction Plates
SPE Sorbent Plates FastLut Plates SPE Tips
48-Well Collection Plates
5 ML, V-BOTTOM 7.5 ML, V-BOTTOM 10 ML, V-BOTTOM
96-Well Collection Plates
2 ML, V-BOTTOM

Microplate Orientation
96-Well Plate Column Indexer

Sample Preparation/Centerfuge
EZ Sample Preparer

Decapping-Capping
Horizon Specialty Capitator Automatic Decapping/Capping Machine

Liquid Handler Rack
96-Tube Rack 192-Tube Rack Custom Rack Reservoir Rack

Choose Time / Date:

DAY OF WEEK: MONTH: DATE: TIME:

Actual Location:
(If different than above)

NAME OF FACILITY(if applicable):

STREET ADDRESS:

CITY OR TOWN: STATE: ZIP:

Contact:

NAME:	POSITION:	TELEPHONE :	EXT:

Unique Requirements/Considerations (This field is Optional):

PLEASE SUBMIT FORM ONLY ONCE!

(Under normal conditions, our geographical area of coverage consists of the Northeast and Mid-Alantic states.)