Please provide the following information:
Required Fields *

Your Company Data
*Company:        *Date:
*Contact:
*Position: Please Select A Title Other Purchasing Engineering Sales Management        If Other Please Specify:
*Type of Company: Please Select The Type of Customer Original Equipment Mfg. End User
*Address:
Address 2:
*City:     *State/Province:  *Zip/Postal code:
*Country:
*Work Phone:       Ext:       Fax:
E-mail:
Names Of Other People Involved:
1.	E-Mail Address:
2.	E-Mail Address:
3.	E-Mail Address:
Distributor Information
Distributor:
Contact Person:
Phone:      Ext:        Fax:
E-Mail:
Material Data
*Material:    *Hardness:
Application Data
*Hole Diameter:      *Tolerance + / -
*Depth of Cut:      Finish Required:
Hole Straightness Required T.I.R.:
True Position:
*Length of Projection Required to Reach Part Surface:
Blind Hole      Thru Hole
Surface:  Machined     Cast
Interrupted Cut:   Yes  No      Describe Interruption:
Machine Data
Machine:
Part Rotating     Part Stationary
Horsepower:
Number of Spindles:
Maximum RPM:
Feeds Per Rev. Available:
*Machine Vertical     *Machine Horizontal
Guide Bushing Length:
Bushing Distance From Part:
*Coolant Thru Spindle:   Yes     No
Coolant Inducer Available:    Yes      No
Type of Holder:      *Coolant PSI:
*Gallons Per Minute:
Type of Coolant:      Mix:
Current Method Data
Using Bushing:   Yes     No     Length of Bushing:
Distance From Part:
*Is Starting Drill Used?  Yes No
* Is Spot Drill Used?  Yes    No
*Type of Drill:
Drill Self Starting:  Yes      No
*Starting Drill Point Angle:
Other Type of Starting Method Used:
Current Operations ( Drilling, Drilling and Reaming, Chamfering, Etc. )
*Current Tool Type:
*Current RPM:      *Feed:       *Peck Drilling:  Yes   No
Cycle Time:   Current Tool Life:
Quantity Of Holes Per    Day:      Week:     Year:
Current Problem:
What Are You Trying To Accomplish:
Comments: