We welcome your interest in joining our team. To assist us in evaluating your request, please fill out the following form:

Your Company / Business Name:>
Your Name and Position / title:>
Phone (include area code):>
Fax (include area code):>
E-Mail:>
Website:>
Address:>
City / Zip Code / Country:>
Which products are you interested in:>
In which country/countries do you focus your sales efforts:>
Where do you focus your sales efforts (E.G. Hospitals,Govt.,OTC etc.):>
Your approximate annual sales & the number of salespeople:>
What kind of distributorship are you looking for with Innovacon? (Innovacon, OEM, others):>
Do you currently sell Rapid Diagnostic Tests:>
If yes, who is the manufacturer:>
Which local or International exhibitions do you attend:>
Which industry related magazines do you subscribe to:>
How did you hear about Innovacon:>
If from Internet, which search engines & what search words:>
What information or samples do you need from Innovacon: >
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