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CUSTOMERS / PRODUCTS FORM

Innova-Specialties Inc.
218 Millwell Dr
Suite B
St. Louis MO 63043

Phone #: (636) 594 0142 - Fax #: (636) 594 2013

Please answer the important questions below to obtain a quick response. Thank you!

1. Custom Service(s) Required:
Small-scale Synthesis
Pilot-scale preparation
Full-scale manufacture

2. Technical description:

3. Quantity to be produced and/or processed:

4. Material Required:

5. Quantity Desired:

6. This inquiry is for:
Costing Purposes Only
Immediate Lab Use
Pilot-scale Work
Current Production Use

7. Your Info:

Company Name:

Your Name:

Address:

Phone Number:*

Fax Number:

Best Time To Contact You:

E-mail Address:*

*Must include either Phone # or E-mail address.

  

 
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