Prototype Request

Prototype Request

Company Name: *

Contact Name: *

Contact Email: *

Contact Phone: *

Ship to Address: *

Chemical Name: *

Manual or Auto: * Manual or Auto:

Felt Height:

Dead Space

Dead Space:

Space between felt and guide. Dimension B in drawing above.

Applicator Type: *

Prime Width:

Primary Surface:

Edge/Side Surface:

Secondary/Back Surface: *if applicable

Applicator or Dimension Requirements: *

Please Attach 2-3 Pictures and/or drawings

Maximum upload size: 134.22MB

Select Your Sales Rep (If Known)

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