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*Denotes required fields
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Contact Information
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*Name
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*Company
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*Street
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*City
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*State
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*Zip
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*Phone
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Fax
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*E-mail
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| Part
Information |
| Description,
Application or Function of Part* |
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| Material |
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| Durometer |
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| Color |
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| Can An
Alternative Material Be Used? Yes
No |
| Application Temperature & Environment |
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| This is a New
Application Redesign
Existing Part |
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This is a Component
Supply Item
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Quality / Inspection
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Level of Quality Reporting Required:
|
| PPAP Required Yes
No |
If so, What
Level? 1 2
3 |
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Are There Critical Dimensions?
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Yes
No
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Is Flash Allowed?
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Yes
No
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| Is Parting
Line Defined? |
Yes
No |
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Is A Special Mold Finish Required?
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Yes
No
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Is Engraving or Special ID Required?
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Yes
No
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| Is Special Packaging Required? |
Yes
No |
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Prototype
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| Is a Prototype
Required? |
Yes
No |
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Prototype to be used as?
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Product Proof Concept
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| Drawing |
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Attach Drawing Now
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Yes
No
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Drawing to be sent by email under separate
cover?
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Yes
No
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Drawing to be faxed?
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Yes
No
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