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RFQ Form

Fill out the form below to submit an email to Midwest Wire Products.

* First Name:
* Last Name:
Title:
* Organization/Company:
Address:
City:
State:
Zip Code:
Phone #:
Fax Number:
* Email:
Please contact me:
Send me information:
* Part Number & Revision Level:
* Part Description:
* Quantities to Quote:
* Annual Quantity Forecasted for this year:
Will you need prototypes?
If yes, how many?
When?
   
Please tell us more about your application for this part:
Are there any finish requirements for your part?
Would you like additional design or material suggestions for this part?
Can we help with value added assembly or packaging of your product?
Please send any CAD files for parts (1):
Please send any CAD files for parts (2):
Please send any CAD files for parts (3):
Please send any CAD files for parts (4):
Please send any CAD files for parts (5):
Or fax drawings to us at 920-743-3777.
Comments:
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