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Information Request Form


Customer Information
Company Date 01/28/2003
Contact* Title
Email* Telephone* Ext
Address1* Fax
Address2 Sales Rep
City* State Zip*
Country Please fill in all of the fields with an asterisk * beside them.


Inquiry Information
Inquiry Type Literature Request  Quote Sales Call Other
What products of ours are you interested in? Fillers Cappers Labelers Conveyors Turntables

Entire Packaging Line Other

Referred By:
Machinery Type.
   
If you know the exact machine(s) you're interested in, please fill in the box to the right with that information.

Project Details


Container, Cap, and Label Specifications
Container Size(s).
Example: 1, 8, 16 or 10ml - 16oz
Container Type Other
Container Composition Other
Container Shape Other
Neck ID(s). Example: 1, 1.5, 2
Cap Type Other
Cap Size(s). Example: 24, 28, 38
Label Application
Label Dimensions.
Example: 1 W x 6 L


Product Specifications
How many products do you fill?
Fill Size(s)
Example: 1, 8, 16 or 10ml - 16oz
Product Type(s) or Name(s).
Example: Cosmetic;
Shampoo & Hair Styling Gels
Product Viscosity Range (CPS)  

  If all of your products are water-thin check this box ?

Does the product foam? Yes   No
Does the product have particulates (chunks)? Yes   No
Fill Temperature Other 
Type of Fill  Other
Contact Parts Other 
Seals Other
Other Characteristics
    (corrosive, etc.)


Other Specifications
Fill Speed Containers Per Minute
Conveyor Chain Other
Conveyor height
Product Travel Left-to-Right    Right-to-Left
Electrical V Ph Hz
Explosion Proof
Additional Information


(For all packaging machinery orders we will require sample containers, product, relevant sketches and diagrams.)

To submit this form you will need to fill in your e-mail address.