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    Name: * sex: mangirl
    job: Telephone: *
    Fax: E-mail: *
    company: * Website:
    address:
    City: * Zip code:
    You are currently using adhesive:
    Please briefly describe the performance of other alternative glues:
    Bonded substrate:
    End use of products:
    Number of parts to be bonded every day:
    Size of bonded area:
    Desired cure rate:
    Adhesive use environment: Extreme temperatureoutdoors High humidity Contact chemicals Other
    Other description:
    Would you consider a two - component adhesive: yes no
    How to use adhesive (sizing method):
    How much time is expected to operate the adhesive:
    Project start time:
    Do you need a dispensing device:
    You need: sample Live demonstration Product literature Sales calls
    Other supplementary instructions:
    Verification Code:   Invisibility?