Please answer the following questions as completely as possible. Your answers will aid our staff in choosing the correct equipment for your particular application. Thank you for your help.

COMPANY NAME CONTACT/NAME E-MAIL TELEPHONE FAX COUNTRY VOLTAGE HZ DESCRIBE PRODUCT TO BE DISPENSED IS THIS PRODUCT SMOOTH? YESNO DOES THIS PRODUCT CONTAIN PARTICLES? YESNO IF "YES", WHAT IS THEIR SIZE? DESCRIBE THE PARTICLES WILL THE PRODUCT BE INJECTED? YESNO DEPOSITED? YESNO HOW MUCH PRODUCT IS TO BE DISPENSED PER CYCLE? DESCRIBE THE FINAL PRODUCT DO YOU NEED A SPECIAL SPOUT? YESNO IF "YES", DESCRIBE THE SPOUT? OTHER SPECIFICATIONS/REQUIREMENTS/ QUESTIONS/FUTURE REQUIREMENTS:

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