Name: ______________________________ Position/ title: ______________________
Company: _______________________________________________________________
Address: ________________________________________________________________
Tel: ____________________ Fax: __________________
E-mail___________________
Therapy Interests:
Technologies Used:
Business Development Sought:
We would like to request more information and schedule meetings
with the following Israeli companies:
1. _____________________________ 3. ___________________________
2. _____________________________ 4. ___________________________