Name*

Position or function

Company*

Address* (street, city)

State* (add zip code)

Country*

Your web site URL

Telephone

Email* (Addresses not sold; privacy respected)

Check item(s) are you interested in*

SGRO

TRVO

Other

Who is the end user?

What is the application? 

Please guess at how many you could use in a year's time

Would you like to establish consulting services from Lumitronics?

Yes

No

Maybe

Later

Salable cost opinions are needed.  New technology is expensive.  Please estimate the maximum your company would initially pay for each ocular unit in order to be among the first or exclusive users.  (This is not a bid.  Please be honest; estimates too low will prohibit marketing whereas estimates too high would invite interference at a crucial stage.) --  Below "<" means "under".

< $1000

< $2000

< $5000

< $10,000

Other $

Estimate the amount your company would pay for each ocular after volume production lowers cost.

< $1000

< $2000

< $5000

< $10,000

Other $