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Rust Questionnaire

All fields marked with * are mandatory.

In order for NTIC to provide you with the most efficient service please complete this questionnaire and hit the "Submit" button at the bottom or the form. 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.

With what component/product do you have currently have a corrosion problem?

Description of part *

Your reference code for this part(s) *

Estimated number of parts requiring corrosion protection

What type of product is the component made of? Check all that apply. *

Ferrous (Iron, Steel, and Cast Iron)

Non-ferrous (Aluminum, Copper, Bronze, and Galvanized Steel)

Silver

How are you currently trying to protect against corrosion? Check all that apply. *

Rust preventive coating

Corrosion inhibiting packaging

Other

Please specify

What is the purpose of the corrosion protection? Check all that apply. *

For ocean shipment

For land transportation

For long-term storage

For in-process protection

Other

Please specify

Which term below best describes your company's supply chain for this component/product? *

OEM

Tier 1

Tier 2

Consolidator/Deconsolidator

Other

Please specify

What is the desired corrosion protection duration from the point of packaging to the point of final use? *

10 to 30 days

31 to 120 days

More than 120 days

Is there a "no-smoke" requirement for this component at the point of final use? *

Yes

Don't know

Is your organization the buyer of our services and products? *

Yes

No, but can strongly influence

Do you have the authority to engage and pay for our services and products? *

Yes

Please provide the name(s) of the authorizing person(s). *

Please provide the names of any other people and/or companies that are affected by this corrosion problem. *

Please provide us any other information that you feel will help us solve the corrosion problem more efficiently. *

YOUR CONTACT INFORMATION

Name *

Job Title

Company

Address

Phone

Email *

Fax

URL

If you were requested to submit the resume by an Zerust representative, please indicate his/her name

©2010 Northern Technologies International Corporation (NTIC). All Rights Reserved. NTIC is the owner of the following trademarks: NTI®, NIC®, ZERUST®, The ZERUST People®, MATCH TECH®, Cor-Tab®, Plastabs®, ICT™, Z-CISSM, COR-SCISM and the Color “Yellow”. EXCOR®, VALENO®, ABRIGO® and UNICO® are registered trademarks of EXCOR GmbH, a Joint Venture Partner of NTIC.