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Phone: 586.727.8890     •    Fax: 586.727.5548     •    PO Box 95, Richmond, MI 48062

Please complete the following information if you would like to request additional information regarding our Charts/Overlays

Items marked with a * are required.
Subject: *
E-mail Address: *
Name: *
Company Name: *
Address: *
City: *
State/Province: *
Zip/Postal Code: *
Country:
Phone: *
Fax:
Comparator Make:
Comparator Model:
Comparator Serial # (If Known):
Quantity Requested:
Magnification:
Increments (If Applicable):
Choose One:
Glass Replacement Screen: *
Screen Diameter (Within .001):
Glass Thickness:
Choose One:
Beveled Edges:
On Front (Size X Angle):
On Rear (Size X Angle):
Chart Clip Lugs:
Quantity:
Threaded:
Drilled Holes:
# of Holes:
Hole Size:
Protractor Edge:
Increments:
Plastic Overlay (Standard thickness of plastic is .050): *
Diameter Required (within 1/4):
Are Notches Needed For Overlay To Fit Around Chart Clips?
Location; Degrees (From horizontal centerline):
Finish (Clear is standard):
Mylar Overlay (Standard thickness of mylar is .007): *
Diameter Required:
Finish (Clear is standard):
Do You Have Any Special Requirements?
How Did You Hear About Us? *
Comments or Other Information:

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