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CC Consent Form

This consent form confirms a collection center's participation in the Kadambini tie-up program with SRL Ranbaxy. By signing the form, the collection center agrees to offer a 10% discount on all tests, excluding international tests, with the discount coming out of the collection center's margins. The signed and stamped form must be returned to an Assistant Manager at SRL Ranbaxy by August 31st, 2006.

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126 views1 page

CC Consent Form

This consent form confirms a collection center's participation in the Kadambini tie-up program with SRL Ranbaxy. By signing the form, the collection center agrees to offer a 10% discount on all tests, excluding international tests, with the discount coming out of the collection center's margins. The signed and stamped form must be returned to an Assistant Manager at SRL Ranbaxy by August 31st, 2006.

Uploaded by

api-3695832
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Consent form for Kadambini

1. Client Code ……….……………………………….

2. Name of the Collection Center ……….………………....……………..

3. Address …………………….…………………..

………………………………………….

4. Pin Code No ……….…………………………………

5. Phone No with STD Code ..………………………………………..

6. Mobile Number ………………………………………….

7. Name of the Contact Person ……….………………………………..

I ……………………………………. hereby confirm our participation in Kadambini Tie-Up


and will offer 10% discount on all the tests (excluding international send out) I Further
understand that above said discounts will be given out of my CC’s margin

Dated: - …………………….. ____________________________

(Signature of the Collection Center)

___________________________
(Stamp)

PS: Please ensure above said form duly signed & stamped should reach to Ms. Shalini
Sharma, Asst. Manager Corporate Communication, Retail Marketing at SRL Ranbaxy,
275/276, Piccadilly House, New Delhi-110065. Phone No- 011-42295365, E-mail-
[email protected] on or before 31st August, 06.

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