{"id":1640,"date":"2026-03-11T13:33:12","date_gmt":"2026-03-11T13:33:12","guid":{"rendered":"https:\/\/www.thefullerene.com\/?page_id=1640"},"modified":"2026-04-11T03:39:37","modified_gmt":"2026-04-11T03:39:37","slug":"request","status":"publish","type":"page","link":"https:\/\/www.thefullerene.com\/ja\/request\/","title":{"rendered":"\u30ea\u30af\u30a8\u30b9\u30c8"},"content":{"rendered":"\n<div class=\"wp-block-greenshift-blocks-row alignfull gspb_row gspb_row-id-gsbp-d9148c4\" id=\"gspb_row-id-gsbp-d9148c4\"><div class=\"gspb_backgroundOverlay\"><\/div><div class=\"gspb_row__content\"> \n<div class=\"wp-block-greenshift-blocks-row-column gspb_row__col--12 gspb_row__col--sm-12 gspb_col-id-gsbp-3307111\" id=\"gspb_col-id-gsbp-3307111\">\n<h1 id=\"gspb_heading-id-gsbp-47a1031\" class=\"gspb_heading gspb_heading-id-gsbp-47a1031 \">Request a Technical Quote &amp; Solution<\/h1>\n\n\n\n<div id=\"gspb_text-id-gsbp-25e005e\" class=\"gspb_text gspb_text-id-gsbp-25e005e \">Connect directly with our senior technical engineers. Whether you require mg-level samples for R&amp;D or tonnage-scale industrial supply, please provide your specific requirements below for a prioritized response within 24 hours.<\/div>\n<\/div>\n <\/div><\/div>\n\n\n\n<div class=\"wp-block-greenshift-blocks-container gspb_container gspb_container-gsbp-f31f449\" id=\"gspb_container-id-gsbp-f31f449\"><style id=\"fluentform-block-custom-styles-2\">.fluentform.fluentform_wrapper_2.ff_guten_block.ff_guten_block-2 .ff-message-success { color: #e65054; }\n.fluentform.fluentform_wrapper_2.ff_guten_block.ff_guten_block-2 .ff-submit-error { color: #e65054; }\n<\/style><div class='fluentform ff-inherit-theme-style fluentform_wrapper_2  ff_guten_block ff_guten_block-2'><form data-form_id=\"2\" id=\"fluentform_2\" class=\"frm-fluent-form fluent_form_2 ff-el-form-top ff_form_instance_2_1 ff-form-loading ffs_inherit_theme\" data-form_instance=\"ff_form_instance_2_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 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id='label_ff_2_names_first_name_' >Your Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_2_names_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 33.33%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_email' id='label_ff_2_email' aria-label=\"Email Adress\">Email Adress<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_2_email\" class=\"ff-el-form-control\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-3' style='flex-basis: 33.33%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_input_text_2' id='label_ff_2_input_text_2' aria-label=\"Organization\">Organization<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" placeholder=\"Company \/ Institution\" data-name=\"input_text_2\" id=\"ff_2_input_text_2\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_dropdown' id='label_ff_2_dropdown' aria-label=\"Industry\">Industry<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_2_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_2_dropdown\"><option value=\"\">&#8211; Select &#8211;<\/option><option value=\"New Energy\"  >New Energy<\/option><option value=\"Biomedicine\"  >Biomedicine<\/option><option value=\"Semiconductors\"  >Semiconductors<\/option><option value=\"Cosmetics\"  >Cosmetics<\/option><option value=\"Academic Research\"  >Academic Research<\/option><option value=\"Others\"  >Others<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_country-list' id='label_ff_2_country-list' aria-label=\"Country\">Country<\/label><\/div><div class='ff-el-input--content'><select name=\"country-list\" id=\"ff_2_country-list\" class=\"ff-el-form-control ff_has_multi_select\" placeholder=\"- Select Country -\" data-name=\"country-list\" aria-invalid='false' aria-required=true><option value=''>&#8211; Select Country &#8211;<\/option><optgroup label=\"\"><option value='GB' >\u30a4\u30ae\u30ea\u30b9 (\u30a4\u30ae\u30ea\u30b9)<\/option><option value='AU' 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>\u30ce\u30fc\u30d5\u30a9\u30fc\u30af\u5cf6<\/option><option value='HT' >\u30cf\u30a4\u30c1<\/option><option value='HU' >\u30cf\u30f3\u30ac\u30ea\u30fc<\/option><option value='HM' >\u30cf\u30fc\u30c9\u5cf6\u3068\u30de\u30af\u30c9\u30ca\u30eb\u30c9\u8af8\u5cf6<\/option><option value='VA' >\u30d0\u30c1\u30ab\u30f3<\/option><option value='VU' >\u30d0\u30cc\u30a2\u30c4<\/option><option value='BS' >\u30d0\u30cf\u30de<\/option><option value='BM' >\u30d0\u30df\u30e5\u30fc\u30c0<\/option><option value='BB' >\u30d0\u30eb\u30d0\u30c9\u30b9<\/option><option value='BD' >\u30d0\u30f3\u30b0\u30e9\u30c7\u30b7\u30e5<\/option><option value='BH' >\u30d0\u30fc\u30ec\u30fc\u30f3<\/option><option value='PK' >\u30d1\u30ad\u30b9\u30bf\u30f3<\/option><option value='PA' >\u30d1\u30ca\u30de<\/option><option value='PG' >\u30d1\u30d7\u30a2\u30cb\u30e5\u30fc\u30ae\u30cb\u30a2<\/option><option value='PY' >\u30d1\u30e9\u30b0\u30a2\u30a4<\/option><option value='PS' >\u30d1\u30ec\u30b9\u30c1\u30ca\u81ea\u6cbb\u533a<\/option><option value='PN' >\u30d4\u30c8\u30b1\u30a2\u30f3<\/option><option value='FJ' >\u30d5\u30a3\u30b8\u30fc<\/option><option value='PH' >\u30d5\u30a3\u30ea\u30d4\u30f3<\/option><option value='FI' >\u30d5\u30a3\u30f3\u30e9\u30f3\u30c9<\/option><option value='FO' >\u30d5\u30a7\u30ed\u30fc\u8af8\u5cf6<\/option><option value='FK' >\u30d5\u30a9\u30fc\u30af\u30e9\u30f3\u30c9\u8af8\u5cf6<\/option><option value='GF' >\u30d5\u30e9\u30f3\u30b9\u9818\u30ae\u30a2\u30ca<\/option><option value='PF' >\u30d5\u30e9\u30f3\u30b9\u9818\u30dd\u30ea\u30cd\u30b7\u30a2<\/option><option value='TF' >\u30d5\u30e9\u30f3\u30b9\u9818\u5357\u65b9\u9818\u571f<\/option><option value='BR' >\u30d6\u30e9\u30b8\u30eb<\/option><option value='BG' >\u30d6\u30eb\u30ac\u30ea\u30a2<\/option><option value='BF' >\u30d6\u30eb\u30ad\u30ca\u30d5\u30a1\u30bd<\/option><option value='BN' >\u30d6\u30eb\u30cd\u30a4<\/option><option value='BI' >\u30d6\u30eb\u30f3\u30b8<\/option><option value='BT' >\u30d6\u30fc\u30bf\u30f3<\/option><option value='BV' >\u30d6\u30fc\u30d9\u5cf6<\/option><option value='PR' >\u30d7\u30a8\u30eb\u30c8\u30ea\u30b3<\/option><option value='VN' >\u30d9\u30c8\u30ca\u30e0<\/option><option value='BJ' >\u30d9\u30ca\u30f3<\/option><option value='VE' >\u30d9\u30cd\u30ba\u30a8\u30e9<\/option><option value='BY' >\u30d9\u30e9\u30eb\u30fc\u30b7<\/option><option value='BZ' >\u30d9\u30ea\u30fc\u30ba<\/option><option value='BE' >\u30d9\u30eb\u30ae\u30fc<\/option><option value='PE' >\u30da\u30eb\u30fc<\/option><option value='HN' >\u30db\u30f3\u30b8\u30e5\u30e9\u30b9<\/option><option value='BA' >\u30dc\u30b9\u30cb\u30a2\u30fb\u30d8\u30eb\u30c4\u30a7\u30b4\u30d3\u30ca<\/option><option value='BW' >\u30dc\u30c4\u30ef\u30ca<\/option><option value='BQ' >\u30dc\u30cd\u30fc\u30eb\u5cf6\u3001\u30bb\u30f3\u30c8\u30fb\u30e6\u30fc\u30b9\u30bf\u30c6\u30a3\u30a6\u30b9\u5cf6\u3001\u30b5\u30d0\u5cf6<\/option><option value='BO' >\u30dc\u30ea\u30d3\u30a2<\/option><option value='PT' >\u30dd\u30eb\u30c8\u30ac\u30eb<\/option><option value='PL' >\u30dd\u30fc\u30e9\u30f3\u30c9<\/option><option value='MG' >\u30de\u30c0\u30ac\u30b9\u30ab\u30eb<\/option><option value='YT' >\u30de\u30e8\u30c3\u30c8<\/option><option value='MW' >\u30de\u30e9\u30a6\u30a4<\/option><option value='ML' >\u30de\u30ea<\/option><option value='MT' >\u30de\u30eb\u30bf<\/option><option value='MQ' >\u30de\u30eb\u30c6\u30a3\u30cb\u30fc\u30af<\/option><option value='MY' >\u30de\u30ec\u30fc\u30b7\u30a2<\/option><option value='IM' >\u30de\u30f3\u5cf6<\/option><option value='MH' >\u30de\u30fc\u30b7\u30e3\u30eb\u8af8\u5cf6<\/option><option value='FM' >\u30df\u30af\u30ed\u30cd\u30b7\u30a2<\/option><option value='MM' >\u30df\u30e3\u30f3\u30de\u30fc<\/option><option value='MX' >\u30e1\u30ad\u30b7\u30b3<\/option><option value='MZ' >\u30e2\u30b6\u30f3\u30d3\u30fc\u30af<\/option><option value='MC' >\u30e2\u30ca\u30b3<\/option><option value='MV' >\u30e2\u30eb\u30c7\u30a3\u30d6<\/option><option value='MD' >\u30e2\u30eb\u30c9\u30d0<\/option><option value='MA' >\u30e2\u30ed\u30c3\u30b3<\/option><option value='MN' >\u30e2\u30f3\u30b4\u30eb<\/option><option value='ME' >\u30e2\u30f3\u30c6\u30cd\u30b0\u30ed<\/option><option value='MS' >\u30e2\u30f3\u30c8\u30bb\u30e9\u30c8<\/option><option value='MU' >\u30e2\u30fc\u30ea\u30b7\u30e3\u30b9<\/option><option value='MR' >\u30e2\u30fc\u30ea\u30bf\u30cb\u30a2<\/option><option value='JO' >\u30e8\u30eb\u30c0\u30f3<\/option><option value='LA' >\u30e9\u30aa\u30b9<\/option><option value='LV' >\u30e9\u30c8\u30d3\u30a2<\/option><option value='LT' >\u30ea\u30c8\u30a2\u30cb\u30a2<\/option><option value='LI' >\u30ea\u30d2\u30c6\u30f3\u30b7\u30e5\u30bf\u30a4\u30f3<\/option><option value='LY' >\u30ea\u30d3\u30a2<\/option><option value='LR' >\u30ea\u30d9\u30ea\u30a2<\/option><option value='LU' >\u30eb\u30af\u30bb\u30f3\u30d6\u30eb\u30af<\/option><option value='RW' >\u30eb\u30ef\u30f3\u30c0<\/option><option value='RO' >\u30eb\u30fc\u30de\u30cb\u30a2<\/option><option value='LS' >\u30ec\u30bd\u30c8<\/option><option value='LB' >\u30ec\u30d0\u30ce\u30f3<\/option><option value='RU' >\u30ed\u30b7\u30a2<\/option><option value='CN' >\u4e2d\u56fd<\/option><option value='MO' >\u4e2d\u56fd\u30de\u30ab\u30aa\u7279\u5225\u884c\u653f\u533a<\/option><option value='CF' >\u4e2d\u592e\u30a2\u30d5\u30ea\u30ab\u5171\u548c\u56fd<\/option><option value='MP' >\u5317\u30de\u30ea\u30a2\u30ca\u8af8\u5cf6<\/option><option value='KP' >\u5317\u671d\u9bae<\/option><option value='ZA' >\u5357\u30a2\u30d5\u30ea\u30ab<\/option><option value='SS' >\u5357\u30b9\u30fc\u30c0\u30f3<\/option><option value='AQ' >\u5357\u6975\u5927\u9678<\/option><option value='TW' >\u53f0\u6e7e<\/option><option value='TG' >\u6301\u3061\u5e30\u308a<\/option><option value='TL' >\u6771\u30c6\u30a3\u30e2\u30fc\u30eb<\/option><option value='IO' >\u82f1\u9818\u30a4\u30f3\u30c9\u6d0b\u9818\u571f<\/option><option value='EH' >\u897f\u30b5\u30cf\u30e9<\/option><option value='GQ' >\u8d64\u9053\u30ae\u30cb\u30a2<\/option><option value='HK' >\u9999\u6e2f<\/option><\/optgroup><\/select><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Interested in becoming an Authorized Regional Agent?\">Interested in becoming an Authorized Regional Agent?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_f226238ca3b682bf7d9c0f42883c26fe'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes, I would like to apply.\"  id='input_radio_1_f226238ca3b682bf7d9c0f42883c26fe' aria-label='Yes, I would like to apply.' aria-invalid='false' aria-required=true> <span>Yes, I would like to apply.<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check- ff_item_selected'><label class='ff-el-form-check-label' for='input_radio_1_d207e3efd01d5b34130e128fe279950c'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" checked=\"1\" value=\"No, just a product inquiry.\"  id='input_radio_1_d207e3efd01d5b34130e128fe279950c' aria-label='No, just a product inquiry.' aria-invalid='false' aria-required=true> <span>No, just a product inquiry.<\/span><\/label><\/div><\/div><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_1 has-conditions'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-2_1\" ><h3 class='ff-el-section-title'>Agency Application Details<\/h3><div class='ff-section_break_desk'><p>Please provide brief details about your business to help us evaluate the partnership.<\/p><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_input_text' id='label_ff_2_input_text' aria-label=\"Current Distribution Channels\">Current Distribution Channels<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" placeholder=\"e.g., E-commerce, B2B wholesale, Laboratory supply networks...\" data-name=\"input_text\" id=\"ff_2_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_input_text_3' id='label_ff_2_input_text_3' aria-label=\"Target Regions\/Markets\">Target Regions\/Markets<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_3\" class=\"ff-el-form-control\" placeholder=\"e.g., North America, EU, Southeast Asia...\" data-name=\"input_text_3\" id=\"ff_2_input_text_3\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Estimated Annual Volume\">Estimated Annual Volume<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_84b8cff9d7d37161d922abe4b3f68a2b'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"10 - 50 kg\"  id='input_radio_2_84b8cff9d7d37161d922abe4b3f68a2b' aria-label='10 - 50 kg' aria-invalid='false' aria-required=true> <span>10 &#8211; 50 kg<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_766726be1af84a200121f367b9f152d9'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"50 - 200kg\"  id='input_radio_2_766726be1af84a200121f367b9f152d9' aria-label='50 - 200kg' aria-invalid='false' aria-required=true> <span>50 &#8211; 200kg<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_e4991a80deb3bd1629f9f25763b48ae5'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"200 - 500kg\"  id='input_radio_2_e4991a80deb3bd1629f9f25763b48ae5' aria-label='200 - 500kg' aria-invalid='false' aria-required=true> <span>200 &#8211; 500kg<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_75886f62d49c657d58a0fc15306454c8'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"500+ kg\"  id='input_radio_2_75886f62d49c657d58a0fc15306454c8' aria-label='500+ kg' aria-invalid='false' aria-required=true> <span>500+ kg<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_f840d8eb8e79a6dff5313203d344dab5'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"To be discussed based on project\"  id='input_radio_2_f840d8eb8e79a6dff5313203d344dab5' aria-label='To be discussed based on project' aria-invalid='false' aria-required=true> <span>To be discussed based on project<\/span><\/label><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_4\"  class='ff-t-container ff-column-container ff_columns_total_2 has-conditions'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Product\">Product<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_9482c548a7b9b6c51df9b630387acde8'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"C\u2086\u2080\"  id='checkbox_9482c548a7b9b6c51df9b630387acde8' aria-label='C\u2086\u2080' aria-invalid='false' aria-required=true> <span>C\u2086\u2080<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6962aa110fd20b4fa0853b06d97195c3'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"C\u2087\u2080\"  id='checkbox_6962aa110fd20b4fa0853b06d97195c3' aria-label='C\u2087\u2080' aria-invalid='false' aria-required=true> <span>C\u2087\u2080<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_b4da5260cce5b68ff320ab2b916715d6'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Mixed\"  id='checkbox_b4da5260cce5b68ff320ab2b916715d6' aria-label='Mixed' aria-invalid='false' aria-required=true> <span>Mixed<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_bf9173c25b763023f569afd694cbfadd'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Functionalized Derivatives\"  id='checkbox_bf9173c25b763023f569afd694cbfadd' aria-label='Functionalized Derivatives' aria-invalid='false' aria-required=true> <span>Functionalized Derivatives<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_numeric_field' id='label_ff_2_numeric_field' aria-label=\"Quantity\">Quantity<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"numeric_field\" id=\"ff_2_numeric_field\" class=\"ff-el-form-control  ff_numeric\" data-name=\"numeric_field\" inputmode=\"decimal\" step=\"any\" data-formatter=\"{&quot;decimal&quot;:&quot;.&quot;,&quot;separator&quot;:&quot;,&quot;,&quot;precision&quot;:2,&quot;symbol&quot;:&quot;&quot;}\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Purity\">Purity<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_46bc9246844a385fc04d77098c2663dd'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Analytical (&gt;99.5%)\"  id='checkbox_1_46bc9246844a385fc04d77098c2663dd' aria-label='Analytical (&gt;99.5%)' aria-invalid='false' aria-required=true> <span>Analytical (&gt;99.5%)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_400a9be0fc2ba53012a6c1de28f3fbdc'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Electronic (&gt;99.9%)\"  id='checkbox_1_400a9be0fc2ba53012a6c1de28f3fbdc' aria-label='Electronic (&gt;99.9%)' aria-invalid='false' aria-required=true> <span>Electronic (&gt;99.9%)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_84e3b72bcdce7e384d432433efac8a54'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Ultra-High (&gt;99.95%)\"  id='checkbox_1_84e3b72bcdce7e384d432433efac8a54' aria-label='Ultra-High (&gt;99.95%)' aria-invalid='false' aria-required=true> <span>Ultra-High (&gt;99.95%)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label ff-other-option' for='checkbox_1_965adc76206d743489b69b8d7c81dc90'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"__ff_other_checkbox_1__\"  id='checkbox_1_965adc76206d743489b69b8d7c81dc90' aria-label='Other' aria-invalid='false' aria-required=true> <span>Other<\/span><\/label><\/div><div class='ff-other-input-wrapper' style='display: none; margin-top: 8px;' data-field='checkbox_1'><input type='text' name='checkbox_1__ff_other_input__' class='ff-el-form-control' placeholder='Please specify...' value=''><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_dropdown_3' id='label_ff_2_dropdown_3' aria-label=\"Unit of measurement\">Unit of measurement<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_3\" id=\"ff_2_dropdown_3\" class=\"ff-el-form-control\" data-name=\"dropdown_3\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_2_dropdown_3\"><option value=\"\">&#8211; Select &#8211;<\/option><option value=\"mg\"  >mg<\/option><option value=\"g\"  >g<\/option><option value=\"kg\"  >kg<\/option><\/select><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_5\"  class='ff-t-container ff-column-container ff_columns_total_1 has-conditions'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_2_message' id='label_ff_2_message' aria-label=\"Application Scene\">Application Scene<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"true\" aria-labelledby=\"label_ff_2_message\" name=\"message\" id=\"ff_2_message\" class=\"ff-el-form-control\" placeholder=\"Briefly describe your application\" rows=\"3\" cols=\"2\" data-name=\"message\" ><\/textarea><\/div><\/div><div class='ff-el-group  ff-dropzone'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_2_file-upload_1' id='label_ff_2_file-upload_1' aria-label=\"Upload Specs\">Upload Specs<\/label><\/div><div class='ff-el-input--content'><label for='ff_2_file-upload_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File Upload your RFP or technical requirements (Optional)<\/span> <input type=\"file\" name=\"file-upload\" id=\"ff_2_file-upload_1\" class=\"ff-el-form-control  ff-screen-reader-element\" data-name=\"file-upload\" multiple=\"1\"  aria-invalid='false' aria-required=false><\/label><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label   aria-label=\"Do you require a signed NDA before discussion?\">Do you require a signed NDA before discussion?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_df726ecbafdbad4dd5a4009f406d4bde'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='input_radio_df726ecbafdbad4dd5a4009f406d4bde' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_d677df58fe2123ddc702040df6223bf5'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='input_radio_d677df58fe2123ddc702040df6223bf5' aria-label='No' 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