What can we do for you?
choose one
I am Requesting Information
I am Requesting Engineering Assistance
Have a Representative Call Me
Send Me a Free Information/Sample Kit
Other
Name* (First and Last)
Phone*
E-mail*
Title
choose one
purchasing agent
engineer
general management
technical
educational
other
Other
Company
Department
Address
Address
cont.
City
State
Zip
Code
Country
Fax
Item Description and Comments :
Please describe the items you would like us to manufacture for you.
Quantity of Item Desired:
please choose one
under 10
more than 10
25
50
100
250
500
1,000
5,000
10,000
Referred
by:
Please choose one
Thomas Register web
site
Thomas Register catalog
Google.com
AOL Search.com
Yahoo.com
Other Internet Search Engine
Advertisement
Other
Referred
by other
If you Need
Engineering Assistance, please Continue below:
Urethane
Hardness
choose one
20A
30A
40A
50A
60A
70A
80A
90A
95A
50D
60D
70D
75D
other
Other
Life
Expectance
Color
What
material is being handled? (eg. paper, steel, chicken parts)
Annual Production
Temperature Range
Machine to be used in
Choose
all that apply:
Sunlight
Solvents
Water
Grease/Oil
FDA/Wet,Dry
Inserts
Enviroment
Critical Properties (eg. abrasion resistance, rebound)
Additional Comments
Contact Information
Applied Urethane Technology, Inc. 6507 Hane Avenue, Baltimore, MD 21237 Call Us Toll Free at: 1-800-823-0040
or (410-485-1070)
Email Us by Clicking on the Link Below: UrethaneServices.com
For fast quotes, FAX us your prints at: 410-485-1071
UrethaneServices.com © Copyright 2010. All Rights Reserved.
View the Applied Urethane Technology, Inc. Copyright Notice
No website content can be duplicated without first obtaining our written permission .