Company Name: ____________________________	Your Name: _________________________
Address: __________________________________	Position:_____________________________
City:________________ State: ______ Zip:_______	Phone:______________  Fax:  _______________
Type and size of material to be placed on reel: _________________________________________
Maximum weight of material to be placed on reel: ______________________________________
Quantities Normally Ordered: _______________
Finish Hole Diameter ( A ):____________________
Start Hole Diameter ( B ):_____________________
Barrel Diameter ( C ):________________________
Distance Center-to-Center ( D ):________________
Arbor Hole Diameter ( E ):____________________
Drive Pin Hole Diameter ( F ): __________________
Flange Diameter ( G ):_______________________
Traverse Length ( H ):_______________________
Overall Traverse ( I ):_______________________
Other: If you want a company name or logo applied to reels, roughly indicate size and position, and state number of colors. ___________________________________________ ___________________________________________