SMD Application Worksheet To complete this form: 1 Fill out the form fields. 2 Save the file to your computer (to make it easy to find save it to your desktop folder). 3 Email the file back to your TriStar contact. For best results, use Adobe Reader.
General Information Date
TriStar Sales Engineer
Company Contact City
Address Phone
State
Zip
Email
Technical Specifications List the material(s) of the device(s) to be treated: Describe the application of the device(s): What are the dimensions of the device:
Length
What is the quantity of devices to be treated:
Width
Sample Qty
What is the objective of applying a surface treatment:
Height
in
mm
Production Qty
Hydrophilic
Hydrophobic
Detack
Clean
Other If the treatment is for a bonding, painting, or printing application, will TriStar SMD be permitted to quote providing a finished part? What surface modification process is the customer currently using:
Sample Processing Information The samples are to be returned to the following address (if different than above): Address
City
Attn
State
Phone
Zip
Email
Please specify desired carrier for the return of the treated samples: UPS
Acct#
FedEx Acct#
Other Acct#
Will Call
TriStar Sales Engineer will Deliver
Please specify delivery option: Overnight
Second Day Delivery
3-5 Day Delivery
Other
If returning by mail
If returning by Email
Please send the samples (and a completed copy of this form) to your local TriStar Plastics Corp. location or send it directly to: TriStar Plastics Corp. - Attn: Surface Modification Division 23655 Via Del Rio, Suite E, Yorba Linda, CA 92887 If you have any questions or comments, please call 800-TRI-STAR (800-874-7827).
Do you have a print of the part available? If yes, please attach it to the email along with this .PDF form.