Microscope Questions

Please enter the information for the questions below.(* Required Fields)

Q1. Do you use a fluorescence microscope? *

• Yes
• No

Q2. How often do you use a fluorescence microscope? *

• Everyday
• Once a week
• Once a month
• None

Q3. Do you have any plans to purchase a microscope? *

• Yes, within 6 months.
• Yes, in 6 - 12 months.
• Yes, more than 12 months from now.
• No plans

Q4. Would you like additional information on our new microscope? (Check all that apply) *

• I would like price info.
• I would like a catalog.
• I want to speak to a sales engineer.
• I want to have an on-site demo and test samples.
• Other requests
• No interest

Q5. If you are not a microscope user, is there someone that you could refer us to that is?
(Referees introduced here will also receive a gift.)

• • First Name

  • Last Name

  • E-Mail Address

  • Company

• • Address

  • State/Provice

  • City

  • Zip/Postal Code

  • Phone/EXT