SILICONE APPLICATION FORM

Civility MissMister

Your surname*

Your name*

Working company*

Company activity*

Fonction*

Adress*

Postal code

City*

Country*

Phone number*

Your e-mail*

Name of your application

Volume per unity (ml)

Unity number a month

Deposit thickness* (mm)

Operating temperature* (°C)

Needed viscosity (cps)

Shore hardness (A,D)

UL94V0*
YesNo

Environment* (humidity, salt spray, vibration...)

Thermal conductivity?*
YesNo

Color

Application method?*
machinemanual

Do you already use a silicone?*
YesNo

If yes, what is the reference of the used silicone?

Conditionning

Price (euros/unité)

ABchimie
Z.A. La Rivoire – 38630 CORBELIN
Tel 04 74 83 12 19 – Fax 04 74 83 68 62
info@abchimie.com

A clear and precise identification of your needs will allow us to head you to one of our specialists in this field. Do not hesitate to inform us as completely as possible.