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                    Since PPE sells by direct mail, we need your assistance in making sure our fully
                  priced molding accessory catalogs get to the right people and the right companies.
                                   Please take a moment to fill out this form, thank you.

        NOTE: Customers Assurance: This information is for PPE only and will not be passed on to any plastics magazine!
        1. What type of plastic processing is done by your company?      University, School
         Assembly of plastic parts     Decorating/Finishing            Plastic Coating, Printing
         BLOW MOLDING                  EXTRUSION                       Machining, Plastics
            Extrusion Blow molding       Blown/Cast Film, Bags         Packaging, Plastics
            Injection Blow molding       Coating, Web                  Recycling, Plastics
            Stretch Blow molding         Pipe/Conduit/Profile/Tube     Pultrusion
         Bonding                         Sheet                         R&D facility
         Calendering                   Fabrication of plastics         Reinforced Composites
         Casting                       Foam molding                    RIM
         Compounding                   INJECTION MOLDING               Rotational molding
         Compression molding           Laminating                      Thermoforming
         None                          Mold or die making              Vacuum Forming
         OTHER PROCESS (Please explain):________________________________________________________
         Approximate number of molding machines: ___________________________________________________
        2. Do you have our latest molding accessory catalog?____________________________________________
        3. Should we add your company name to our mailing list?__________________________________________
        4. Do you have other locations doing plastic molding?____________________________________________
           (If yes, please give us the addresses below).
        5. Please list your complete MAILING information below (we may call you to verify).
        COMPANY NAME:__________________________________________________________________________________________________________

        STREET: __________________________________________________________________________________________________________________
        CITY: __________________________________STATE/ __________________________ COUNTRY: _____________________ ZIP: ____________
        P.O. BOX: ______________CITY: _____________________STATE/ _________________ COUNTRY: _____________________ ZIP: ____________
        TELEPHONE: ___________________________ FAX: ___________________________ EMAIL: ____________________________________________
        YOUR NAME:  ___________________________________________TITLE: ____________________________________________________________
        PRODUCTS OF INTEREST: __________________________________________________________________________________________________

                                                                          Form Completed By: ________________________
                                                                                       Date: ________________________

                  PLASTIC PROCESS EQUIPMENT, INC.                                 • e-mail:
                   PPE    6385 Montessouri Street, Las Vegas, Nevada 89113  PPE  11218 Challenger Avenue, Odessa, Florida 33556
                   W E S T  702-433-6385 • 800-258-8877 • Fax: 702-433-6388  SOUTH  727-834-8888 • 800-282-6783 • Fax: 727-834-8873
                  8303 CORPORATE PARK DRIVE, MACEDONIA (Cleveland), OHIO 44056, USA         Toll Free: USA, Canada & Mexico
            PPE   216-367-7000 • Toll Free: 800-321-0562 • Fax: 216-367-7022 • Order Fax: 800-223-8305  800-362-0706
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