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  1. Are MSDS(s) being recieved and filed for all chemicals used at your facility? Yes No
  2. Name of person to receive MSDS(s):
  3. How many people are currently employed at your facility?
  4. Will your company's employees have adequate knowledge and training to handle Durez materials correctly and safely? Yes No
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  7. Please define the Durez product of interest. If unknown, please list performance or specification requirements:
  8. My application/market is:
  9. Is this an existing application? Yes No
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  11. Are you requesting a sample? Yes No
  12. Is the ship-to address different from the address above? Yes No
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