REQUEST FOR PRODUCTS/SERVICES

Contact Name
Title
Company
Address
Phone (Office)
Email Address
Application
Name of the equipment or aircraft that needs protection
Problems encountered Check all that apply	Sand   Rain   Others
Agency involved with this problem or application
Length of time it takes for erosion damage to appear:
Frequency of repairs:
Current solutions/materials used on this application:
Substrates that need protection: (Metal? Composite? What is the generic chemical nature?)
Operation environments:	Select Salt Water Fresh Water Sand UV Temperature range
Visual color needed:	Select Clear Colored Opaque Gloss Matte
Application thickness anticipated:
Maximum film thickness allowed:
Dimension of the parts to be coated or protected:
Size of the actual area to be coated or protected:
Number of units involved with this problem or application:
Realistic time schedule/deadline that needs to be met:
If an optimized solution is found for your application, how many units will be candidates for this solution immediately? In the future?
Do you have funding available to do some customized work to find the best solutions?	Yes   No
To speed up contract award process, will your company be interested in working through the SBIR Phase III ID/IQ contract?	Yes   No
Additional Comments: