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Free LENTICULE® Disc Sample Offer

If you would like to receive a free LENTICULE Disc sample please complete and submit the form below. Terms & Conditions apply.

LENTICULE Disc - Free Sample Request Form

 

I would like to receive a free LENTICULE Disc sample.

(Please select the LENTICULE Disc you would like from the list below.)

 

At this time we are limiting the offer to a choice of three strains, however, please note below any other strains and cfu ranges you are particularly interested in:

 

Related Link: LENTICULE Discs Full Listing 

 

Before sending out your free sample we will need some vital contact details from you for delivery purposes. In addition, we would be grateful if you answered a few questions.

 

1.Where did you hear about this offer?  
2.What organisation type do you belong to? 
3.

What do you use cultures for?

Please indicate your field(s) of interest in relation to the use of LENTICULE Discs

  

   

  

  

 

 

  

 

4.

How long have you been aware of LENTICULE Discs?       
5.Have you used LENTICULE Discs before? 

6a.

 

 

 

 

 

6b.

Where do you obtain your cultures from?

 

 

 

 

 

If you buy in stock, where do you obtain your cultures from?

 

 

 

  
7.

How often do you start up microbial cultures?

       
Contact Details 
 

 First Name:

  
 

Last Name:

  
 

 Job Title:

  
 

 Organisation Name:

  
 

Department Name:

  
 

 Contact Tel:

  
 

 Contact Email:

  
 

Fax no:

  
 
 

Address Line 1

 
 

Address Line 2

 
 

Address Line 3

 
 

Address Line 4

 
 

Town

County/State

 
 

Postcode/Zip Code

 
 

Country

 

 

Please enter delivery address, if different from above.

 

 

 Organisation Name:

  
 

Department Name:

  
 

 Contact Tel:

  
 

Address Line 1

 
 

Address Line 2

 
 

Address Line 3

 
 

Address Line 4

 
 

Town

County/State

 
 

Postcode/Zip Code

 
 

Country

 

 

Thank you for taking the time to answer our questions, once you have submitted your form we will contact you and arrange delivery of your free sample.