Buyer Request Form

Please take the time to fill out the following Request Form.
Our staff will answer your request shortly
.

(* to be completed)
Company Name*
Contact Person*
Address*
City*
Province/State
Postal/Zip
Country*
Phone*
Fax*
Email*

PRODUCTS
 

 LENTILS Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 BEANS Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 PEAS Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 CHICK PEAS Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 GRAIN SEEDS Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 WHEAT Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 ANIMAL FEED Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 
 OTHER Type  Grade 
 Packaging  Retail Pack 
Quantity 
Quantity Type 

Delivery Terms 
Shipment Position 
Final Destination 

Comments

Simex InternationalSimex International
HOME | CONTACT | ABOUT US | PRODUCTS | ORDER FORM | LINKS
ENGLISH
FRANÇAIS