Inner coil brush order form

*One-byte kana characters cannot be used. Input all numbers using one-byte alphanumeric characters.

Your company name

Department name
Person in charge
Postal code (e.g.: 111-1111)
Address (e.g.: XYZ City ABC 1-2-3)

Telephone number (e.g.: 111-111-1111)

Fax number  (e.g.: 111-111-1111)
e-mail address
Specification diagram available
  Yes   No

1.External diameter (DΦ)
2.Internal diameter (dΦ)
3.Brush length (effective face length)
4.Brush fiber material
Please write any opinions, requests, questions, etc. you may have.
Press send once you have finished filling out the form.
Thank you.

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