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Application Assessment Form

Please fill in all the information requested below, and attach part drawing if available

To receive a quote, please fill out the following information and click "Submit".
A:
A+/-:
B:
B +/-:
C:
D:
E:
R:
AA:
AA +/-:
BB:
BB +/-:
F:
G:
Part Name:
Material:*
Estimated Annual Number of Holes:*
Hardness:
Part Drawing:
Special Notes:
Job Currently in Production?*
- Yes
- No
How soon after order is placed will you need the tool?
MACHINE INFORMATION
This information is important in determining what style of tool will best fit your application.
Machine Make:
Spindle Type (CAT50, HSK63, ETC.):
Quill Type Spindle?:
- First Choice
- Second Choice
- Third Choice
Through Coolant?:*
Coolant Pressure:
Contact Information
Name*
First Last
Company Name*
Industry
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Job Title
Job Responsibility (distributor or enduser)*
Are you interested in H.Bilz Products?
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