Testimonial Submission Form

Does CORECHEM have permission to use your testimonial for Marketing purposes?*

Option 1: I hereby authorize CORECHEM, Inc to publish my words as a testimonial for marketing purposes. The city in which my company is located will be mentioned as well as the nature of my business, but not my company name. My first name and last initial will be published. (i.e. “Bob S. at Manufacturer in Dallas, TX”) Option 2: I hereby authorize CORECHEM, Inc to publish my words as a testimonial for marketing purposes. The city in which my company is located will be mentioned as well as the nature of my business, but not my company name. My title will be used in place of my name. (i.e. “General Manager at Manufacturer in Dallas, TX”) Option 3: I hereby authorize CORECHEM, Inc to publish my words as a testimonial for marketing purposes. I request that my testimonial be published anonymously. Option 4: I do not authorize CORECHEM, Inc to publish my words for marketing purposes.

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