Company and Engineer's Information:
* Name      
   Title         
   Company 
   Address   
                   
* Phone Number
   Fax Number     
* Email Address  

Equipment Details
Main Extruder Brand
Extruder Size
Satellite Extruder Brand
Entry Side and Hook Up
Back Opening and Bolt Pattern and Size (attach drawing or fax)

Die Style Desired
Prototype Die (Flat Plate)
Hard Run Die (Streamlined)
Die Size (if specific)
Heaters Needed yes
Tubing Head Needed yes
Pin and Bushings Size(s)

Sizing Needed yes

Sizing Style Desired
Air Racked
Water Cooled
Vacuum
Other specified

Cutter Bushings Needed
yes

Extruder Adaptor Needed
yes

Material to be run
RPVC
FPVC
Polycarbonate/Lexan
Styrene
Polystyrene
HIPS
Polyurethane
Santoprene
Thermoplastic Rubber
LDPE
Polypropolyene
Acrylic
Foam
Wood Composite
Butyrate
Noryl
Rovel
Other:

Secondary Material
RPVC
FPVC
Polycarbonate/Lexan
Styrene
Polystyrene
HIPS
Polyurethane
Santoprene
Thermoplastic Rubber
LDPE
HDPE
LDPE
EVA
TPE
ABS Nylon
Polypropolyene
Acrylic
Foam
Wood Composite
Butyrate
Noryl
Rovel
Other:

From Your Browser Menu Bar, Select "File" and "Print" to print this Form.
and
"Submit" to email this form to ETTI.

Project/Part Details
This is best done by attaching a part drawing/sketch and faxing it to 847.526.7443.
Or mail a sample to:
ETTI
1000 Rand Road
Unit 210
Wauconda, Illinois 60084 USA

Or by fax:
Print and fax this form with your part drawing/sketch to 847.526.7443.

Or by phone:
By placing a call to Wes Scott, President at 847.526.1606 to discuss your project.