Form A
WAG Submitter
Please Select
Achim Grenner
AJ Strandquist
Alexander Stemper
Andrew Tordanato
Benjamin Cybulski
Darren Brubaker
Ed Tackett
Felix Muench
Grant Michel
Jacob Ayers
Javier Pacheco
Joe Tonoff
Joshua Barber
Katelyn Lennon
Michael Johnson
Mikhael Gladkikh
Sabina Terzic
Victor Kurtz
Luke Li
End Customer Email - Leave Blank if Unknown
example@example.com
Wurth OPCO
Please Select
Wurth Industrial US
Wurth MSM
Wurth Construction Services
Wurth Revcar
Wurth Marine Fasteners
Wurth Industry Mexico
Wurth Industry Brazil
Wurth Additive Group
New Business Development - WINA
Wurth Industry Canada
Wurth Australia
Wurth Japan
Wurth France
Wurth Craft Line
Wurth Northern Safety
OPCO Reps Involved - First & Last Name
Deal Name
End Customer Company - If Known
Part Purpose
Benchmark
Production Part
RFQ
One-Off Request
IP-Owner
File Upload 1
Browse Files
Drag and drop files here
Choose a file
Cancel
of
File Upload 2
Browse Files
Drag and drop files here
Choose a file
Cancel
of
File Upload 3
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Requested Due Date
-
Month
-
Day
Year
Date
Application - Detailed Description
Submit
Should be Empty: