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Faxable Printer Friendly Version PDF File


To e-mail your order, please fill out the form below and press “Submit”. If you would prefer to fax your order please use our printer friendly form and fax it to us at 1.888.229.9918 toll-free, or 905.288.6101 locally. Please note that orders for BD Biosciences Discovery Labware products need to be placed through VWR International (www.vwr.com) at 1.800.932.5000.

You will receive an order confirmation within 24 business hours of receipt of your order.

NOTE:  We do not recommend that you place credit card orders on this form, as the website does not currently support secure billing. If paying by credit card, please print out this form using our printer friendly version, complete it in full and fax it to BD Biosciences toll-free at 1.888.229.9918, or locally at 905.542.9391. Alternatively, you may call us at 1.888.259.0197, or locally at 905.288.6000. We welcome all e-mail orders paid by Purchase Order or Grant Number.

The fields marked with an asterisk (*) are mandatory.

As with all internet communications, e-mail sent to or from this site may not be secure and you should therefore take special care in deciding what information you send to us. Our collection, use and disclosure of personal data through this site are governed by our Privacy Statement and Consent to Use of Data which you should carefully review before providing information to us. Please also note that the e-mail links and forms on this site are not for emergency or medical information.

*Purchaser's Name:
*Purchaser's Phone Number:
(Please include 3 digit area code)
Extention:
*Billing Information (one of the below is mandatory):
Yes, I have a customer number:
If a particular field is not applicable to you, please type "n/a" in these mandatory fields.
Billing Address:  
*Institution
*Department
*Room Number
*Street Address
*City/Town
*Province
*Postal Code
*Attention to:
*Shipping Information
*Institution
*Department
*Room Number
*Street Address
*City/Town
*Province
*Postal Code
*Attention to:
*Payment Method (one of the following is mandatory)

At this time, we do not accept credit card orders over the Internet.
For credit card orders, please print this form and fax us the order with your credit card number.

PO Number
Grant Number
Quote Number (if applicable)
Please List Desired Items
*Catalogue Number Description Lot Number
(if available)
Quantity Price
Additional Comments:

*I would like to receive my order confirmation by: (one of the following is mandatory)
E-mail:
Telehone:
Extension:
Fax:

Before submitting personal information to us, we encourage you to read our Privacy Statement and Consent to Use of Data. This Statement contains important information about how we will handle and use your personal information. After you have had a chance to review the Statement, please acknowledge your acceptance of terms by selecting the box below. If you choose not to accept, the information you just completed will not be submitted to BD.

I accept the terms of the Privacy Statement.

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