order form

Secure Sockets Layer (SSL)

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Delivery Address 

Name
First name 
Company
Street  
Zip Code, Town. 
State
Phone
Fax
Email  



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( Please fill out the following only if you want us to indicate your ordering code and our vendor number on the invoice)

Your ordering code
Our vendor number


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Invoice Address 

( Only necessary when delivery address and invoice address are different)

Name 
First Name
Company 
Street
Zip Code, Town
State , Country
Phone
Fax
Email.


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Please indicate mode of payment:



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Credit Card Information

Card holder
Card number
Expiry date
CVC2 Code


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For EU (European Union): If you have a VAT (IVA, TVA) number, please indicate it in this field. Otherwise we have to charge the VAT in accordance to the law.

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Our products are delivered by DPD, Priority parcel and EMS



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I order:


pieces
pieces
pieces
pieces
pieces

If you want to send us any other information or specification concerning your order, please use this fext field [ max. 200 characters]

YES, I would like to receive the LMscope (Micro Tech Lab) newsletter.