Dymax Worldwide • English • Español • Deutsch • Français • 中文 • 한국어

SEARCH

Home	ISO 9001 Certified

Request an ADHESIVE SAMPLE
( ELECTRONIC )

Please provide as much information as possible. This will allow us to verify that the product selected is going to provide you with the best solution.

Fields marked with an (*) are required.

If you have already requested an adhesive sample through our website in the past and would like another material, please contact our Applications Engineering Group at 860-482-1010 for further assistance.

Contact Information

General Contact Information
*Salutation:
*First Name:
*Last Name:
*Title:
*Company:
*Address:

*City:
*State/Province:
*Postal Code:
*Country:
*Phone:
Fax:
*Email:

Ship to Information Please complete if different than contact information
*Salutation:
*First Name:
*Last Name:
*Title:
*Company:
*Address:

*City:
*State/Province:
*Postal Code:
*Country:
*Phone:
Fax:
*Email:

Application Information
*How did you hear about DYMAX?
Are you currently working with a DYMAX Sales Partner?
*If "Yes" who?

*Shipping Carrier:

**Account Number:

**An account number must be provided if you select a Federal Express or UPS service, otherwise the sample will be shipped via First Class Mail.
*End item to be manufactured with DYMAX product (examples: catheter, turbine blade, cell phone, etc.):

*Describe the application (description & purpose of material):

*Substrates to be bonded or coated (list any coatings and list specific plastics):

Shadowed Areas:

Current Method
Current Product Name:

Current Chemistry:

If "Other" or "None" Please Specify:

Proposed Process
How many parts will you manufacture per hour?
Manufacturing Process:
How do you plan to dispense and cure the proposed material?

Do you have a UV light source?
*If yes, what kind?

Adhesive Requirements
*Physical Properties (viscosity, hardness/flexibility, color, clarity, or fluorescence needed):

*How do you plan to test the proposed material? (adhesion, thermal, moisture/humidity):

Additional comments or requirements:

Product(s) selected:


Want to know about the latest DYMAX products and news? Opt-in to receive our bimonthly Light Lines newsletter. You can opt-out anytime. View samples.
Yes, please! No, thanks.

Security Code: Enter the code shown below (this helps us prevent spam)

Privacy Policy: We value your interest in the DYMAX website and hope you'll return often, seeking solutions for your bonding and coating challenges. Because of this, we consider your contact information and any other information that you provide us as confidential. This means, most importantly, that we do not sell your contact information to anyone. Instead, your information is used by us solely to provide you with the information and assistance you have requested. View our complete privacy policy.

Request an ADHESIVE SAMPLE ( ELECTRONIC )

Request an ADHESIVE SAMPLE
( ELECTRONIC )