Custom Order Form

Staple
Application (end use):
Overall Length L:
Inside Width C:
Wire Size D:
Wire Shape:
	Round Square
Cleat:
	Uncleated Annular Thread Deep
Finish:
	Plain Zinc Galvanized Mill Galvanized Stainless Steel Copper Clad Other:
Quantity:	LBS. or  pcs.
Bulk Pack:	LBS. per Keg:    or Pieces per Keg:
Notes, Tolerances, Heat Treating and Other Specifications:
Name and Address Information
Name:
Title:
Company:
Address:
Apt/Suite:
City State Zip:
Phone:
Fax:
E-Mail: