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New Customer Enquiry

Thank you for your interest in L.R. Instruments and our product lines. To assist us in processing your enquiry as quickly as possible, it would help us greatly if you could complete the form below. This way we can establish the correct information is supplied.

Contact Details

An asterisk ( * ) denotes a required field. Please make sure that you enter this information so that we can attend to your enquiry efficiently. Either Australian Client section or New Zealand Client section - no need to complete both sections.

Australian Clients

* Full Name: *
* Company Name: *
Postal Address:
Suburb:
State:
Postcode:

New Zealand Clients

* Full Name: *
* Company Name: *
Postal Address:
Suburb:
Town / City :
Postcode:

Direct Contact Details

* Phone: *
* Email: *

Reason for Enquiry

Are you an End User?

* Please describe your business
Would you like to become a New Distributor of our products?
If yes, what products are you interested in?
If no, what is the reason for your enquiry?
What else would you like information on?

Form Verification

This area is used to stop the robot scripts from maliciously sending form spam and hijacking web forms.
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LATEST UPDATE: 30 MAY 2011