Application Worksheet

Worksheet

Injection molding machine Application Worksheet

Name(Required)

First Last

Company(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Fax

Website

Email(Required)

Product size ( Length )

Product size ( Width )

Product size ( Height )

Product weight

Mold size ( Length )

Mold size ( Width )

Mold size ( Height )

Cycle time required

Send Photo of Products

Drop files here or

Max. file size: 256 MB.

If customer already have a mold machine, which brand

Screw diameter

Motor power

Pump output

Special Requirements

Application Description/Special Requirements

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