Contact Contact

Sample RequestSample Request

The free product sample of the physics and chemistry equipment sales ‘Osaka Chemical’ can be requested here. Please transmit after inputting the wanted product by the following sample request form or Fax.


Request by Fax

Please print out and use this page after putting check in either “Autosampler vial”, “All Plastic Syringe” or “other product” in the top of following form.

Fax：06-6311-1070


Request sample form

At first, please put the click in either “Autosampler vial” or “All Plastic Syringe”or “other product”.And then, please input necessary items, and click [confirm] button. You move to the confirmation screen of content. When the mistake is not found, click the button,and it becomes “request completion”.We contact to you as soon as we can confirm it.


requiredFirst name
requiredLast name
requiredCompany
Part section
requiredCompany address
  • 〒
requiredPhone
Fax
requiredE-Mail
requiredre-entry
requiredHoped reporting method

Please input it if you have the company purchased that hopes.

Company purchased
Person in charge
Phone
Fax

Please input the End user name in the case of the application of the dealer.
Please input the information of the yourself in the case of the end user.

End user
Part section
Company address
  • 〒
Person in charge
Phone
Fax

Hope sumple(up to three per one item)

Product NO.
Product name
Hope number
Product NO.
Product name
Hope number
Product NO.
Product name
Hope number

Please inquire when you don’t find the wanted product in the Product list.

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