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»Business Name:
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»Address:
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» City:
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»State:
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»Zip Code:
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»Contact Person:
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»Job Title:
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»Work Phone:
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Fax:
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»Email:
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Cell Phone:
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Industry:
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Place of use:
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Clean room
Processing area
Laboratory
Manufacturing area
Other -
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Number of employees:
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Shoe cover usage (# of
pairs)
per person per shift:
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Type of shoe covers already using:
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Plastic
Fabric with traction
Fabric
Heavy-duty, waterproof
Non-slip, waterproof
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Interest in other related products:
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Shoe Cover Remover
Boot Covers
Sticky Mats
Disposable Gloves
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Any other information/details:
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*Please enter the following code into the box provided:
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