Donate to an Environmental Charity

In keeping with our new Corporate Green theme, Atrion will make a $500 donation to the Environmental Charity of your choice, for the first 20 qualified inquiries on our Atrion Product Compliance Solutions relating to 2009 compliance project initiatives. To be eligible for the Environmental Charity donation please complete our contact details form and a member of our Business Consultancy group will assist you with the questionnaire during a brief discovery call. All entries must be submitted by December 31st, 2008*.

Salutation:*	Mr. Ms. Mrs. Dr. Prof.
First Name:*
Last Name:*
Email:*
Title / Position:*
Company:*
Address:*
City:*
Zip:*
Province / State:
Country:*
Phone:*
Fax:
Questions regarding your 2009 compliance initiatives:
Project Planning:
What is driving you to make changes to your existing compliance system?:*
What is your decision-making timeline for this project?:*	Less than 12 months Less than 24 months More than 24 months
Integration:
Do you have a centralized compliance system?:*	Yes No I dont know.
Are you planning on integrating your compliance system to a central ERP framework?:*	Yes No
If YES, which ERP system are you planning to integrate with?:
REACH and GHS:
How many countries are you currently maintaining REACH and GHS information for?:*
Product Life Cycle:
Is maintaining documented compliance procedures causing delays in product life cycle management?:*	Yes No
Environmental Charity Donation:
Name of Environmental Organization:
Environmental Organization's Website:
Verification No.:*

* Limit of 1 environmental charity donation per company.