Sample Request

Product Name:

Sample Size Requirements:

Minimum volume/weight:

Package Type:

SyringeSqueeze BottleOther

UV Curing Equipment Available:

If a light curable product is recommended, do you have industrial grade Light Curing Equipment available?YesNo
If yes, please identify the Manufacturer Model and Footprint type: Spot SystemFlood SystemConveyorized UV Curing System

Your Name (required):

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Last

Company:

 Position:

Phone (required):

Fax:

Email Address (required):

If samples are requested and if different from “Contact Information” above.

Your Name:

First

Last

Company:

Phone:

Email Address:

Samples will be shipped from Tangent via UPS ground (as applicable).

How Did You Hear About Tangent Industries, Inc?:

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