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
How Many Parts are you submitting?
*
Please Select
1
2
3
4
5
Next Step
Schedule Tech Assessment
Send to Quote
Part 1 - File Name
*
Part 1 - Printer Technology
FDM/FFF
DLP
LPBF
MJF
DMLS
DED
SLS
SLA
Metal Binder Jet
Part 1 - Material Request
Part 1 - Quantity
Parts File Upload (Zip Folder)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Application Description - If Needed
Part 2 - File Name
*
Part 2 - Printer Technology
FDM/FFF
DLP
LPBF
MJF
DMLS
DED
SLS
SLA
Metal Binder Jet
Part 2 - Material Request
Part 2 - Quantity
Part 3 - File Name
*
Part 3 - Printer Technology
FDM/FFF
DLP
LPBF
MJF
DMLS
DED
SLS
SLA
Metal Binder Jet
Part 3 - Material Request
Part 3 - Quantity
Part 4 - File Name
*
Part 4 - Printer Technology
FDM/FFF
DLP
LPBF
MJF
DMLS
DED
SLS
SLA
Metal Binder Jet
Part 4 - Material Request
Part 4 - Quantity
Part 5 - File Name
*
Part 5 - Printer Technology
FDM/FFF
DLP
LPBF
MJF
DMLS
DED
SLS
SLA
Metal Binder Jet
Part 5 - Material Request
Part 5 - Quantity
Submit
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