Request for Statico Literature and Samples

Statico Line Card

Please provide the following information.

Disclosure: The information below is strictly confidential. The purpose of this questionnaire is to expedite your literature request and materials samples.

Literature Requested

Please check all that apply.	Meters, Monitors and Ionizers Grounding Systems Grounding Straps (Wrist) Heel / Toe Grounding Antistatic Tapes Table / Floor Matting ESD Protective Packaging Other Materials (please describe below):
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Please Have a Representative Contact Me

Preference	As soon as possible After I have received your literature Please do not call; I will call Barry Technical Sales when ready.
Preferred method of contact.	Telephone Fax E-Mail In Person by Appointment at My Location
Best times to reach you.	Mornings Mid-Day Afternoons Evenings / Weekends
Best times to meet you by appointment.	Mornings Mid-Day Afternoons
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Contact Information

Organization Name
Type of Business
Industry
Contact Name:
Contact Title
Contact Phone
Contact Fax
E-mail address
Address 1
Address 2
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NEW INFO >> E-Mail BTS 847-550-1277 412 Bramble Ln. Deer Park, IL 60056 USA