Refer a Friend Nominee Form

You’ve been nominated to explore the benefits of GloMax®. Complete the form below to let us know which system you’re interested in, and we’ll be in touch with more details 

I am interested in the following instruments
 
 
 
GloMax® Navigator
 
 
 
 
GloMax® Explorer
 
 
 
 
GloMax® Discover
 
 
 
 
 
 
 
First Name*
 
 
 
 
Last Name*
 
 
 
 
Email*
 
 
 
Institute / Organisation*
 
 
Phone
 
 
 
Job Title Category*
 
 
Country*
 
 
 
Additional Comments
 
 
Yes, I authorise Promega to process my data according to GDPR*
 
 
I want to receive e-mails about new products, promotions, events and technologies*
 
Yes
No