Online Partner Application

 

Yes, I/we would like to register in the Biospace Corporation Online Partner Program. I/we agree to add the custom Online Partner Page to my/our site in return for a Commission on Sales made through my/our site. I/we have read and agree to the Terms and Conditions of the Online Partner Agreement.

Any information you submit below is held strictly confidential.

ASSOCIATE WEB PRESENCE
Partner Class

Partner Website

Partner Promotion

Your WebPage URL

Name for Your OPP Page

ASSOCIATE DETAILS
* First Name
* Last Name
Title
Company
 * Shipping Address(1)
Shipping Address(2)
 * City
* State or Province
* Country
* Zip or Postal Code
Telephone No.
Fax No.
* E-mail


If "Server Error" appears, please click "Back" and "Place Order" again.
**If you have Security concerns, you can call (or print & fax Form) toll free to:
1-800-592-5286 (Canada & USA) or 905-278-0296 (Local & International).

Please direct written inquiries to:

BIOSPACE CORPORATION
1720 Lincolnshire Blvd.,
Mississauga, Canada L5E 2S7
Tel/Fax (905) 278-0296

E-mail: sales@biospace-corporation.com

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Wall-Album®, SUPERSTRIPS™, PlayMaker®, Bathbar® & Washbar® are trademarks of Biospace Corporation.
Biospace® is a registered trademark of Biospace International AG. © Biospace Corporation.
All rights reserved. U.S. and International Patents apply or are pending.

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