Sample Request Form
Contact Information
Shipping Information (if different)
First Name:
Last Name:
Company:
Address:
City:
State: Zip:
Phone:
Fax:

First Name:
Last Name:
Company:
Address:
City:
State: Zip:
Phone:
Fax:

Email:
Website:

Basic Sample Information
Request Type: Anodizing Type:
Customer Type: Alloy Designation:
Required Oxide Thickness: mils microns Alloy Temper:

ShippingInformation
Est. Ship Date: Method of Shipment:

Type of Part and Use
Current Process or Specification (if any):

Performance/Technical Comments:

Post-Anodize Processing
Type of Seal
Type of Dye/Color
Color Process

Comments on Post Treatment: