Re-Order Form
Name:
Company Name:
Address 1:
Address 2:
City, St., Zip
Country:
Telephones:
Fax:
E-mail Address:
P/N or DWG Ref:
Revision Number:
Description : Brief description of the part including size (dia, L X W) and quantities of holes, slots, slits, cutouts, flats, and/or waste edges (for example: 2.0 sq. X .025 with 16 cells at .500 sq. with each cell containing 6 holes at .010):
Please give us information regarding the material:
Material Type:
Special Material Specifications (if desired):	96% Alumina 99.5% Alumina 99.6% Alumina Other
Supplying Material:
Size:
Is supplied material metalized or does it require post-processing?:
Quantities to quote:
Immediate Buy or Budgetary Purposes?
Date:
Comments: