ENQUIRY FORM

Name*:
Designation:
Company Name :
Address*:
Country*:
Telephone:	- -
Fax*:	- -
Mobile:	- -
E-mail*:

Name of items, specifications, applications and quantity*:
Target Price(if possible):		C&F CIF FOB
Mode of Shipment*:		Sea Air Courier
Port of Destination*:
Any other Detail:
If full specifications of required items are not available, you may send samples at the following address: Shalimar Rubber and Plastic Industries 901,GD ITL Tower, B-08, Netaji Subhash Place, Ring Road, Pitampura, New Delhi-110034, INDIA. Ph: +0091-11-27352466, 27351467 Fax +0091-11-27351468, 27672374 Fields denoted by * are compulsory fields