Please type the required information in each field and then activate the “PRINT” button to obtain
a pdf version. Customers should print and sign the completed form, and then return it to Kinexus
Bioinformatics Corporation by facsimile transmission to 1-604-323-2548 or by e-mail to firstname.lastname@example.org.
Should you have any questions, please contact our Technical Services representatives at 1-866-Kinexus
(in North America) or 1-604-323-2547 Ext. 1. Once you have placed a product order with Kinexus, we will
endeavor to ship the product within 2 business days or you will be contacted if there is a delay.