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| In order for NTIC to provide you with the most efficient service
please complete this questionnaire and hit the "Submit" button at the bottom of the form. |
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| Please submit an answer for all questions. If you don’t have an answer for the question,
simply state, No answer or Don’t know. Thank you. |
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| 1. Currently In which component/product do you have a corrosion problem? |
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| 2. What type of metal is the component made of? Check all that apply. |
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| 3. How are you currently trying to protect against corrosion? Check all that apply. |
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| 4. What is the purpose of the corrosion protection? Check all that apply. |
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| 5. Which term below best describes your company's supply chain for this component/product? |
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| 6. What is the desired corrosion protection duration from the point of packaging to the
point of final use? |
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| 7. Is there a "no-smoke" requirement for this component at the point of final use? |
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| 8. Is your organization the buyer of our services and products? |
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| 9. Do you have the authority to engage and pay for our services and products? If not, please provide the name(s) of the authorizing person(s) |
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| 10. Please provide the names of any other people and/or companies that are affected by this
corrosion problem. |
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| 11. Please provide us any other information that you feel will help us solve the corrosion
problem more efficiently. |
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| YOUR CONTACT INFORMATION : |
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