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Grinding Media Quotation Request Form

* Required fields  
* Company Name:
* Mailing Address:
* City:
  
* State/Province:
  
* Zip/Postal Code:
* Country:
Contact Information
* Contact Name:
* Title:
* Phone:
   Fax:
* Email Address:

What mill are you using?
Mill Manufacturer:
Mill Size:
Mill Model:
   
What material are you grinding?
   
What media do you require?
   
What size media?
   
What quantity?
   
How Did You Hear About Us? (check all that apply)
  Google – list keyword if remembered:
ThomasNet.com
Magazine Ad – name of publication:
Press Release
Trade Show – name of show:
E-Blast
E-Newsletter
Bing Search
Yahoo! Search
Referral from colleague
Past customer
 
Additional Comments:

Quotation Standards:
All grinding media is quoted F.O.B. Union Process.
Grinding media quotations are valid for 30 days from date of quote.
Payment terms will be specified on the formal quote.

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