| 1.Have you ever used any dispenser?:
Yes
No |
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| If
'Yes', |
| 2.Type: |
Air pressure dispenser
Peristyle Tubing dispenser
Double-fluid mixing discharge
Gear pump dispenser |
Piston pump dispenser
Screw pump dispenser
Others |
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| 3.Liquid: |
Instant adhesives(=instant glues=cyanoacrylate)
Anaerobic adhesives
UV adhesives
Paint
Primer
Ink
Magnetic fluid
Flux |
Oil
Solvent
Pastes
Resin adhesives
Others |
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| 4.Liquid viscosity: |
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| 5.Discharge: |
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| 6.Manufacturer of the dispenser: |
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| 7.Your dissatisfaction with
the dispenser: |
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| 8.The assembly process where you use
the dispenser: |
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| 9.If
'No', |
|
Under consideration
Interested
Not interested
Others |
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| 10.For further information: |
You want to use our demonstrating dispenser
You want us to visit your company. |
You want to ask for our catalogs.
To purchase
Others |
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| 11.Please
write your requests and comments |
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|
|
| About
your company |
| 12.Your name: |
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| 13.Company name: |
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| 14.Position: |
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| 15.Address: |
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| 16.TEL: |
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| 17.FAX: |
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| 18.e-mail: |
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