Europe's leading HPLC column manufacturer.

Founded in 1978

Hichrom Limited Customer Order Form

Order Information

Contact the sales department on:

Tel: +44 (0) 118 930 3660 Post: Print this form and post to
Fax: +44 (0) 118 932 3484 Hichrom Limited
1 The Markham Centre
Station Road
Theale Berks
UK RG7 4PE

Or complete the following order form and submit

Delivery Address
Title Name
Company Dept
Address Postcode
Invoice Address
tick if same as delivery      
Title Name
Company Dept
Address Postcode
Special Instructions    
Order Details
Purchaser Name Contact Telephone
    Contact Email
P/O Number VAT exempt (please fax certificate)
Type of delivery Account Number
Item Catalogue No. Description Unit Price Qty. Total Price
1
2
3
4
5
6
7
Special Instructions or
quote offer reference
Confirmation of order required?
All orders will incur shipping charges at our standard rates - contact Hichrom for details
Credit card
Name on card
Card number
Expiration Date


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