First Name
Last Name
Company Name
Address
City
State ---AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming
Zipcode
Company Type DistributorWholesalerManufacturerConsumerOther
If you chose "Other" as Company Type, please explain
Email (required)
Phone Number (required)
Fax Number
Brush Quantities Needed
Brush Application
A. Brush Diameter (inches)
B. Brush Length (inches)
C. Overall Length (inches)
D. End Type ---Pipe NipplePlastic HandleWood HandleStraight StemLoop End
– If Loop End is requested, Loop End Diameter (inches)
Note: If end loop is requested on brushes made with nylon, poly or natural filament, they will have a "bent loop".
E. Stem Diameter (inches)
F. Stem Material
G. Brush Filament Diameter (inches)
H. Filament Type ---NylonPolypropylenePolyesterTampicoHorse HairBrassPhosphorous BronzeStainless SteelCarbon SteelOther
– If "Other" is selected, please indicate type
– Level or Crimped ---LevelCrimped
– Filament Color
I. Fill Amount ---LightMediumHeavy
J. Tip Style ---Twisted EndVinyl TipBlunt EndTurned TuftOther
– If "Other" is selected, please indicate type:
K. Tip Length (inches)
L. Twisted Wire ---Single Spiral/Single StemSingle Spiral/Double StemDouble Spiral/Double Stem
M. Stem Length (inches)
Additional Information
Δ