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    Engis Corporation
    Call:  +1-847-808-9400
    or 800-993-6447
    Email:  info@engis.com

    Engis Corporation
    Engis Corporation
    Engis Corporation
    105 West Hintz Road
    Wheeling, Illinois 60090
    Fax: +1-847-808-9430
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    Hyprez Process Development Labs
    Engis Corporation

    The following questionnaire is designed to help us understand the requirements for processing your sample parts. Please answer the questions with as much detail as possible.

    Please contact us at 847-808-9400 should you have any questions.
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    Customer Information
    *Company Name:
     
    Engis Corporation
    *Company Address:
     
    Engis Corporation
    *Contact Name:
     
    *Telephone:
     
    *Email:
     
    Is a non-disclosure agreement needed: Yes    No    Existing
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    Incoming Sample Part Quality and Information:
    RMA#:
     
    Engis Corporation
    Part# and description:
     
    Engis Corporation
    Dimensional size of parts:
     
     
    (Whenever possible, please include sample parts finished to requirement along with any respective blueprints)
    Material:
     
     
    (If more than one type, please elaborate)
    Is material heat sensitive?
     
     
    (If yes, please indicate which chemicals to avoid under specific conditions)
    Hardness:
     
    Number of parts:
     
     
    (Certain Engis systems/processes require a minimum of parts. Please verify prior to sending)
    Remaining parts should be returned to
    customer after processing is complete: Yes    No
    Incoming surface finish:
     
     
    (Numerical Ra where applicable)
    Incoming surface flatness:
     
     
    (Where applicable)
    Number of surfaces
    to be finished:
     
    Primary shape of
    samples submitted:
     
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    Processing Instructions and Requirements:
    Engis Corporation
    Amount of stock to be removed :
     
     
    (Please include any metrological equipment & instrumentation used for inspection)
    Units:
     
       
     
    Requirement
     
    Tolerance/Units
    Thickness:
       
    Parallelism:
       
    Flatness:
       
    Surface Finish:
       

    Are the sample parts substrates/wafers?:   Yes No
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    Engis Corporation
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         Engis Corporation   •   105 West Hintz Road   •   Wheeling, Illinois 60090   •   Call: +1-847-808-9400   •   Fax: +1-847-808-9430Engis CorporationEngis CorporationEngis Corporation
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