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Subject

Your First Name *

Your Last Name *

Your Email *

Company Name *

Your Phone Number *

Date Required *

Is a Sample Required? *

Street Address 1 *

Street Address 2

City *

State/Province/Region *

Postal/Zip Code *

Country United States of AmericaCanadaMexico

Color Match Information

Compound ID Number *

Color Name *

Select One:
---RematchNew Color

Application *

Resin Type - Select One:
---CompoundDry Blend

End Product - Select One:
---IndoorOutdoor

Part Thickness - Select all that apply:
Single WallDouble WallTeflon Coated Mold

Colorant Requirements - Select all that apply:
FDAHeavy Metal FreeNone

Coloring Tolerance*
---CriticalCloseCommercial

Additional Comments

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