Your Name:
Your Title:
Company Name:
Address:
Phone Number:
Email:
Type of application (specific)?
If you are considering a competitive material, will you provide small (1 sq. ft.) sample?
Yes
No
What is the estimated market size for your application?
What are the estimated annual purchases (by pounds, square feet, lineal feet, or dollars, etc.) of Stevens Urethane?
What is the required thickness and tolerance of the film/sheet?
Thickness:
Tolerance:
What durometer (Shore hardness) material is required for the application?
Material:
Shore A
Shore D
What is the required width and tolerance of the film/sheet?
Width:
Tolerance:
Is color a factor?
Yes
No
If yes, specify color:
What surface finish does the application require?
Nothing special
Matte-1
Matte-2
B-Matte
Glossy 2
Other (specify):
Does the film/sheet need to be UV stabilized:
Yes
No
Does the film/sheet require a specific appearance?
Nothing special
Transparent
Translucent
Opaque
Other (specify):
How is the film/sheet going to be processed?
What is the desired melting point of the film?
Melt point (C):
Melt point (F):
Does the application require a flame-retardant material?
Yes
No
Indicate which of the following standards the film/sheet must meet for this application:
None in particular
ANSI/NSF 61 Potable
USP Class VI
FDA 21 CFR (177.2600)
FDA 21 CFR (177.1680)
Other (specify):
Will the film/sheet be exposed to moisture or humidity?
Yes
No
Are there any chemical compatibility concerns with the film/sheet in this application?
Yes
No
If yes, specify chemical(s) and concentrations:
Are there any other important characteristics that the film/sheet must exhibit for this application?
Do you need a product sample?
Yes
No
If yes, please specify quantity:
Length:
Width:
Thickness:
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