SMD Application Worksheet - HubSpot

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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.

TriStar Corp.

tstar.com

1.800.874.7827

Rev. 2015c