GM RFQ Form

Lead Source
Lead Source Description
Secondary Lead Source
Secondary Lead Source Description
Name*
E-mail*
example@example.com
Company*
Title*
Country*
State*
Province*
City*
Message*
Last Name*
Address
Zip/Postal Code
Phone Number
Please indicate which product you are interested in (mandatory):

CANADIZE®DYNALOY®ELECTROLESS NICKELGOLDENEDGE®HARD ANODIZINGHI-T-LUBE®LECTROFLUOR®MAGNADIZE®MAGNAGOLD®MAGNAPLATE HCR®MAGNAPLATE HMF®NEDOX®PLASMADIZE®POLYMER COATINGSTHERMAL SPRAYTHIN DENSE CHROMETITANIUM NITRIDETUFRAM®
Other (please specify):
Would you like to be contacted by a Magnaplate technical representative?

YesNo
What problem are you trying to resolve? (Use description field)

Specific ApplicationPerformance Problem
Describe your specific application or the performance problem:
Please describe your general industry classification

AerospaceChemicalsFoodOil/Gas/MiningPackaging EquipmentPharmaceuticalsPlastics/RubberMachine ToolsTextilesElectronics/Business EquipmentOther
Would you like us to prepare a quote?

YesNo
If yes, please attach the drawing

Total size of upload should not exceed 30MB. If you need to send larger files, please email contact@magnaplate.com
Cancelof
What are quantities associated with this application?
Are there any special instructions to include?

StrippingMaskingSpecificationsOperating ConditionsOther
Where did you hear about General Magnaplate (optional)?
Please verify that you are human*
Should be Empty: