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First Name
Last Name
Company
Address
City
State
Country
Zip
Telephone
Fax
Email
Other
Describe Your Application / Situation
Equipment
(e.g. Kolbus, Potdevin, Manual ...)
Adhesive Type
Cake Glue
Dehydrated Glue
Dextrin
Hot Melt
Water Based Resin
Glue Dots
Select a Type
Is this operation new?
yes
No
Are you in production now?
yes
No
Adhesive Usage Per Month
Current Supplier
Product Currently Being Used
Price Currently Being Paid
(denote units: pounds, skid, etc.) Example: $25 per Lb.
LD Davis Industries, Inc. ©2008
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