Fisher Fisher Lead Submission Form Please fill out the following form to secure business to your customer. All submissions are time stamped and will be verified as original leads by Implen. Your entries are automatically converted to a spreadsheet which can be used for follow-up and forecasting. Feel free to make any changes to the spreadsheet such as notes or sales funnel stage. Implen maintains a backup of entries with time stamp.Sales Rep Name*Customer First Name*Customer Last Name*Title*Dr.Prof.Mr.Ms.Mrs.MissPosition* PI Lab Manager Postdoc Grad Student Tech Other Company/Institution*Institute*Lab/PI Name*Business PhoneEmail Street Address*Street Address including Mail Code or Lab LocationCity*Postal Code*Country*Lead Source*VisitAdvertisementExhibitionColleagueBlogGoogleWebshopPurchasing Timeframe / Budget Availability* Immediately within 1 year within 3 months over 1 year within 6 months Product of Interest* N120 N50 NP80 C40 N60 CFR21 Software Applications & Needs Nucleic Acids Proteins Wavescan Kinetics Cuvette Capability Other Indicator of likeliness to close. Can be updated in shared spreadsheet.10%30%60%90%100%Competitor(s)*Customer needsHow do we win?Status/Next StepAdditional NotesCustomer needs, purchasing time, etc How many days in a week* this Spam Captcha is powered by Gravity Captcha. Please confirm that Implen is authorized to store your information and use it according to our privacy guidelines. You may recall this authorization at any time, please contact our support team to do so.Consent* I consent to having Implen store my information
