Questionaire: Tempering Beakers

Please answer the questions and send the filled out questionaire to us.
In consideration of your information we will work out an offer with a drawing an send it to you as sson as possible.

Mandatory fields marked *

Material
1. Kind
Temperature Usage
1. Temperature
Content
1. Content
Dimensions
1. Inner diameter
2. Outer diameter
3. Inner height
Connection Thermal Jacket
1. Kind
Insulation
1. conventional
Comment
1. Comments or Customer Wishes
Sender
1. Company *
2. Department (if any)
3. Title
4. First Name
5. Surname*
6. Street*
7. Postal Code*
8. City*
9. Country*
10. Phone
11. Fax
12. Email *