New Customer Form | Mylnefield Lipid Analysis | The James Hutton Institute

Customer Detail Form

New customers should completed this form in full. It will be sent to Claire Traynor, Head of Mylnefield Lipid Analysis and to Sales Ledger Administrator, Stella Bell.

You will receive confirmation of receipt. If you believe you made any errors or omissions, please contact Claire Traynor

Business/Organisation Name

Please provide the relevant contact/s information for reports and samples ...

CONTACT 1

Name

Email

Phone

Address

Address 2

City/Town

ZIP/Postal Code

Country

CONTACT 2 (IF RELEVANT)

Name

Email

Phone

Address

Address 2

City/Town

ZIP/Postal Code

Country

Please provide the relevant contact information for invoicing ...

Name

Email

Phone

Address

Address 2

City/Town

ZIP/Postal Code

Country

VAT (TVA) Registration Number (if applicable)

Company registered number (if applicable)

Names of authorised signatories

How did you hear about Mylnefield Lipid Analysis?

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