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Name (First and Last)*    
Company    
Street Address*    
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Zip*    
Phone*    
Contact*    
Email*    
Print Furnished    
CAD File Furnished    
Approx Part Weight*    Lbs.  Ounces Grams
Material*    
Color*    
Quantity (Estimated annual usage)*    
Release Quantities*    
Release Frequency   Week  Month Year
Estimated Cycle Time*    
Does Mold / Tooling Exist?    
If Yes: tool size; Length    
If Yes: tool size; Width    
If Yes: tool size; Height    
If Yes: What size press did it run in? (tonnage)    
If No; Is there a prototype tool?    
Is new tooling required?    
Industry served    
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