Sample Requisition Form

    PLEASE INDICATE THE PRODUCTS YOU WOULD LIKE TO DISCUSS IN THE FORM BELOW.


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    PLEASE COMPLETE THE ATTACHED FORM TO REQUEST CONTACT FROM OUR SALES TEAM TO DISCUSS AN EVALUATION OF OUR CONSUMABLES.





    31/12/2020










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    I AM AWARE OF THE FOXYLOGY SDN BHD PRIVACY POLICY.

    I EXPRESSLY CONSENT THAT MY PERSONAL DATA CAN BE CONTINUOUSLY STORED AND USED BY FOXYLOGY SDN BHD FOR ADVERTISING OR MARKETING PURPOSES, E.G. FOR PROVIDING INFORMATION AND OFFERS CONCERNING THE GOODS AND SERVICES OF FOXYLOGY SDN BHD BY EMAIL, MAIL, WEBSITE, SOCIAL MEDIA, PRINTED MATERIAL OR PHONE. THIS CONSENT IS VOLUNTARY AND CAN BE WITHDRAWN COMPLETELY OR PARTLY AT ANY TIME WITH FUTURE EFFECT AT NO CHARGE. WE WILL ERASE YOUR DATA UPON RECEIPT OF THE WITHDRAWAL.

    BY CLICKING THE SUBMIT BUTTON BELOW, I HEREBY AGREE TO AND ACCEPT THE TERMS AND CONDITIONS ABOVEMENTIONED.

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