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Special Offers from Agilent

For customers in China and Taiwan, please complete form in Chinese only.

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YES! I would like to receive information about products and services from Agilent Technologies via e-mail.

Choose your FREE sample pack of Agilent LC supplies: [check one]

	Econofilter syringe filters
	2 mL vials


1.	How many Agilent LC or LC/MS systems do you operate/maintain? 1-5 6-10 11-15 16 or more

2.	How many injections do you run per day? 0-20 21-50 51 or more

3.	Who is your preferred source for buying Agilent supplies? Agilent Agilent authorized distributor Other

4.	Are you interested in purchasing Agilent instruments, consumables, and services? Yes No

5.	What is your time frame for purchasing? 3-6 months 7-9 months 10-12 months More than 12 months

6.	Do you have a budget plan for purchasing? Yes, my available budget is (US Dollars) No budget available Currently applying for budget Don't know

Offer valid through October 31, 2005, and where not prohibited by legislation.
Limited quantities available.