| Company Information |
| * Company
Name |
|
* Name |
|
| Address |
|
Position |
|
| City,
St., Zip |
|
* Phone |
|
| * E-Mail |
|
Fax |
|
| Project
Information |
| Application/Part
Name |
|
| R&D
or Existing Application? |
|
| End Use
of Product |
|
| Application
Information |
| Substrate
#1 |
|
Substrate
#2 |
|
| Temperature
Requirement |
|
C or F |
|
| Chemical
Resistance? |
|
| If Yes,
Explain in Detail Below: |
|
| Strength
Requirements |
|
| Customary
Defined Test Methods |
|
| Required
Open Time |
|
Required
Fixture Time |
|
| Gap
Size |
|
Auto or
Manual Dispense |
|
| Current
Adhesive |
|
Packaging
Size |
|
| Previously
tested adhesives |
|
| Problems
with current or tested adhesives |
|
| Additional
requirements not mentioned above |
|
| Additional
information regarding application |
|
|
| * Denotes Required Field |
