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* = Mandatory Input
FAX FORM or CLICK BELOW FOR IMMEDIATE ATTENTION:
305-553-1841
305-819-3299
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Please Specify* |
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Mr.Mrs.Ms. |
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Family Name* |
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Given Name* |
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Job Title |
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Company Name* |
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E-mail Address* |
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Homepage Address/URL* |
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Telephone (Country Code)
(area code + phone) |
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Fax (area code +
phone) |
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Address* |
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City |
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State |
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Country* |
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Zip/Postal
Code |
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Your Business Detail:
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We are: |
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Year of Establishment
(optional) |
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Annual Sales volume in
US$ (optional) |
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Number of Employees
(optional) |
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Please describe you business in no more than 200
words *
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Where did you learn
about ARD? |
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Affiliate Link or
Referral? |
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Buyer or Seller Referral |
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Submission of this section of the form will allow us to check
our computer database to match suppliers or buyers. ARD has over 30 million databased
suppliers and buyers from all over the world. |
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**Buying or
selling Halon and related gas items** |
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Please tell us about the type of product (Halon Gas or related
Halogenated product) t\you are looking for. **Indicates numeric/date fields. Please
leave it blank if your requirement is negotiable. |
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Name of Product |
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Photo |
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Max file size: 50K bytes. Type: GIF/JPG. |
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Sample Quantity |
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Urgency |
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Purchasing quantity or
selling price |
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Target purchasing or
selling price |
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Expected delivery or
export date |
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Product classification |
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Details of product
(function, specification, size, packing, requirement etc.) Please put in as much detail as
possible. |
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Import remarks (e.g. any
standard requirements) |
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