STEP 1: Type of Product or Service:

FOR LIFT TABLES:

Please fill out the following

Click here to view a larger version of this image

A =  B = D =  E = LH =  EH =    Please Check Mounting Method Mounting Method 1 Mounting Method 2 Mounting Method 3 No. Units Required:   Options (Velcro): Top: Bottom: Maintenance Ties: 1 - sided skirt 2 - sided skirt 3 - sided skirt 4 - sided skirt 5 - sided skirt

FOR CURTAINS / SPLASH OR SAFETY CURTAINS

Size (LxW):
Colour:
Weight:
Application:
Other:

STEP 2: Your Contact Information:

Name:
Email:
Company:
Phone Number:
Method of Contact:		Telephone Email
Best Time of Day:		Mornings Afternoons
Comments:
How did you find out about M.I.R.		E-Mail  Referral         Internet Search Engine