Innov-X Canada - Contact Us!

Please complete the fields below and an Innov-X Canada Representative will respond to you shortly.

First Name: *
Last Name: *
Position Title:
Company Name:
Address Street 1:
Address Street 2:
City:
Postal Code:
Province/State: *
Phone: *
Email Address: *
Promo Code:
Enquiry Type: *
Application/Industry: *
Elements of Interest:
Comments:	Enter comments here! Please be as specific as possible so that we can direct you to the very best person to find your solution!
Mailing List	Yes, please add me to your mailing list

Contact Information

Tip: You can provide a brief description of your form. Also, you may want to let your customers know what happens after they submit the form. For example, upon form submission, they would be added to your contact list.

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Comments:	Enter comments here!