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Address 1*

Address 2

City ,State ,Zip*

Your Name*

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Job Function

Application Info

Joint Type

Subtrate 1 What is the surface you are bonding to, including the coating type. For example: To receive a correct and accurate recommendation, if a steel panel is coated with Kynar® paint, the substrate should be listed as Kynar®, NOT steel.

Subtrate 2 What is the surface you are bonding to, including the coating type. For example: To receive a correct and accurate recommendation, if a steel panel is coated with Kynar® paint, the substrate should be listed as Kynar®, NOT steel.

Application Temp Range( F^o):

Service Temp Range( F^o):

Exterior Application?YesNo

UV Resistance?StrongSomeNone

Chemical Resistance?YesNo

Please list chemical type

Must meet the following specifications:

Additional Comments How soon do you need a solution? How often do you need purchase, packaging requirements, price range, or constraint, color, viscosity (flow), problems with current products, or any additional information to include?