Maxwell Instrument Enquiry From | Demo Request

Which instrument would you like pricing information for?*

Are you interested in an instrument demo?*

Yes

No

What type of targets does your lab purify? (please check all that apply)

Genomic DNA

Total RNA

Polyhistidine or HQ Proteins

Viral Total Nucleic Acid

Plant DNA/RNA

DNA From Raw or Processed Foods

ccfDNA

miRNA

Other

If other, please specify?

What sample types do you use?

What type of research are you performing?

First Name*

Last Name*

Email*

Company/Institute*

Department*

Building/Room/Lab*

Street Address*

City*

State/Province/Region (If applicable)*

Postal/Zip Code*

Country - Full List*

Phone

How would you like to be contacted*

Phone

Email

I want to receive e-mails about new products and technologies, promotions, webinars and events. (Optional)

I have read and agree to the Promega Guidelines for Processing Personal Information (see link below)*

Promega Guidelines for Processing Personal Information

Products may not be available in all countries. After completing this form, we will contact you if the instrument about which you are inquiring is not available in your country.

Maxwell Instrument Please Enquire Form

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