Title: 

Company: 

Address: 

City: 

State or Province:  Zip or Post Code: 

Country: 

Phone Number (please include area code): 

FAX Number (please include area code): 

E-mail address: 

Type Of Grinding (check one):

Thrufeed Centerless 
Infeed Centerless 
Nut Inserted Disc 
Camshaft 
Surface
Creep Feed
Other (please describe):

Wheel Information & Process Data

Outer Diameter:   Thickness: 
Inner Diameter:   Other Information: 

Machine:   Horsepower:   R.P.M.:  

Name of Part:   Part Material: 
Material Hardness:  Finish Required: 
Total Removal:   Removal/Pass: 
Pieces Per Dress:   Dress Depth: 

Current Wheel Specification:  

What improvements to wheel performance and/or your process are most important to your company?: 

Please enter any specific requests or comments in the box below: