1.

Contact Information

* Indicates Required Fields
*Company:
*First Name:
*Last Name:
*Title:
*E-mail:
*Address1:
Address2:
*City:
*State:
*Zip Code:
*Country:
*Phone: Ext:
Fax:
Job Function:
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2.

Quote Details

Annual Quantity:
Date Required:
Target Price:

Run Type

Ongoing
One time order
Prototyping or Development

3.

Cross-Section Drawing

Select the desired cross-section sketch below. If the desired cross section does not appear in this menu, please fax a sketch or design after completing this form. If you prefer, you may also print out this PDF worksheet and fax it to 414.423.0562.

 

4.

Technical Requirements

Tubing Design:

Materials:
If Other:
Material/Manufacturer:
Material Grade/Durometer:


Fillers:

 %
If Other:
Color:
Pantone#:


Tubing Dimensions:
ID:   ±
OD:    ±
WT:   ±
Length:   ±


Heat Shrink Tubing Dimensions:

Minimum Expanded ID:
Maximum Recovered ID:
Recovered WT:    ±
Length:   ±


Special Requirements

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