Core Restorer - Customer Specifications

Customer Information:

Company Name:
Date:
Individual Contact:
Title:
Address Line 1:
Address Line 2:
City:
State/Province:
Country
Postal Code
Telephone:
Fax:
Email Address:

Application Information :

Core diameter(s): What is the wall thickness for each core diameter?:
Core material: Roll Diameter (in.):
Roll material: Roll weight (lbs.):
Other comments: