PCL Enquiry Form

 
 

If previous customer please quote your Customer Code no. (as found on previous invoices)

 
 

Contact name:

 
 

Contact position:

 
 

Company name:

 
 

Address:

 
 

 

 
 

 

 
 

Postcode/ Zip code:

 
 

Country:

 
 

 

 
 

Tel No. (include international dial code)

 
 

Fax No. (include international dial code)

 
 

E-mail:

 
 

Webpage address:

 
       
 

Enquiry Details

     
 

What type of product would you like to enquire about?

Polymex product:

 
 

 

Rolls:

 
   

Sheets:

 
   

Other:

 
 

Product/ Polymex Code: (Enter as many products/ codes as you desire)

 
 

What information is required?

 
 

Intended Application:

 
 
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