If you require a quotation on multiple pieces of equipment with different specifications either:
A) Contact us directly by calling 770-449-8810.
B) Print the blank form multiple times, complete relevant sections and fax it to us at 770-416-8460.
C) Submit a separate form for each piece of equipment.

Full Name:
Title:
Company:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State:
Zip Code:
Country:
Phone:
Fax:
E-mail Address:
Application (Film, Sheet, etc.):
Information Required for Extrusion Control Quotations:
Configuration:	Mono Layer Co-Extrusion
Number of Extruders:
Line Speed Control Required?	Yes No
Extruder    Max Throughput (lb/hr, kg/hr) Material (Pellets, Powder or Regrind) Bulk Density Free Flowing (Y/N) High Temp 1 2 3 4 5 6 7
Additional Extrusion Control Request Comments: