We invite your inquiry to learn more about our:

• Prompt written quotes;
• Highly trained work force;
• Modern plant and production facility;
• Dependable pickup and delivery service;
• Stringent inspection and quality control;
• Guaranteed customer satisfaction.

Fill out the following short survey so that we may assist
you with a plan to economically meet your labor needs.

Please enter a detailed description of the type of work
your labor force performs in the space provided below:

What is the annual volume (in units) produced?

If the annual volume (in units) is seasonal,
Can you give a month by month breakdown?

Do you have any unique requirements for
PACKAGING, SHIPPING or INVENTORY?

Do you have any special quality control
or inspection requirements?

Do you have any special turnaround time requirements?

Please tell us how to get in touch with you:
(*required)

Contact Name*:	
Company Name*:	
Address*:	
City*:		
State*:		
Zip*:		
Email*:		
Work Phone:	
Other Phone:	
Fax:		

Click The Arrow To Tell Us How To Best Contact You ->Contact By Work PhoneContact By Other PhoneContact By FaxContact By E-Mail

What Time Of Day Is Best To Contact You?
Click The Arrow To Choose The Time ->12:00 Noon1:002:003:004:005:006:007:008:009:0010:0011:0012:00 Midnight     AM     PM

Please contact me as soon as possible regarding this matter.

3 WAYS TO CONACT US:

1) You may Call Us at 1-800-989-3996 or 1-330-296-2839
2) Print and Fax this form to 1-330-296-8875
3) SIMPLY PRESS THE "SUBMIT" BUTTON BELOW !!!

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Portage Industries, Inc. 7008 State Route 88 Ravenna, OH 44266

Toll Free: 1-800-989-3996 Local: 330-296-2839 Fax: 330-296-8875

info@portageind.org

Copyright 1997 Portage Industries, Incorporated, all rights reserved
Portage Industries, Incorporated is a non-profit organization.