Tech Sales Co., Information Request Form

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First Name
Last Name
Title
Company
Address
City
Province/State
Postal/Zip Code
Telephone Area Code	-
Fax Area Code	-
E-mail
Number of Employees	1-4 5-10 10-19 20-49 50-99 100-249 249-499 500+ Self Employed
Industry Classification (click one)	Pulp and Paper Petroleum, Coal/Natural Gas Rubber Plastic Materials Metal Processors Food Processing Beverage Manufacturer Non-Metallic Minerals Textiles Pharmaceuticals Detergents/Cleaning Compounds Protective Coatings Utilities Consulting Engineer Government Other
Other Please Specify:
Job Function (check one)	Administrative Manager Operative Mangement Plant Engineering Consulting Engineer Purchasing Research & Development Other

I would like more information on the following products:

1 - EXAIR Super Air Amplifiers

2 - EXAIR Cold Gun Air Coolant Systems

3 - EXAIR Air Nozzles and Jets

4 - EXAIR Super Air Knife Static Elimination

5 - EXAIR Line Vacs Air Operated Conveyors

6 - Air Shafts Safety Chucks

7 - Exair Cabinet Coolers

8 - Carbicote Strippable Coatings

9 - Corona and Arc Plasma Surface Treatment Systems

10 - Desolvit Non Toxic Degreasers

11 - Blue Power Safe Water Based Degreasers

12 - Siege Water Based Cleaners/Degreasers

13 - EXAIR Products Air Knife, Cabinet Coolers, Nozzles, Vortex Tubes & More!

14 - Filtration Fabrics Non Woven

15 - Hot Stamping Machines

16 - EXAIR Vac-u-Gun

17 - EXAIR Drum Vac System

18 - EXAIR Chip Vac

19 - Industrial Work Stations Qualtech

20 - Magnetic Brakes & Clutches

21 - Marking Systems, Laser, Wheel Type, Stylus and Scriber Markers

22 - Mini Oil Skimmers

23 - Plastic Flaw Repair

24 - Roll Handling Systems

25 - Core Chucks

26 - EXAIR Adjustable Spot Coolers

27 - EXAIR Mini Coolers

28 - EXAIR Component Coolers

29 - EXAIR Ion Air Gun

30 - EXAIR Ion Air Cannon

31 - EXAIR Super Ion Air Knife

32 - HAUG Tristat TR 25 Charging Generator

33 - HAUG Ionizing Bar

34 - Exair Vortex Tubes

Thank you