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Text File  |  1995-10-16  |  1.1 KB  |  36 lines
  1. Fill out and Mail to:
  2. Stock Drive Products
  3. Mr. Herb Arum
  4. 2101 Jericho Turnpike
  5. Box 5416
  6. New Hyde Park, NY 10042-5416
  7.  
  8. Idea Engine / Entrepreneurial Inventor Questionaire:
  9.  
  10. 1. Name: _______________________________________________
  11.  
  12. 2. Company: ____________________________________________
  13.  
  14. 3. Title: ________________________________________________
  15.  
  16. 4. Address: _____________________________________________
  17.  
  18. 5. City, State, Zip: _______________________________________
  19.  
  20. 6. Telephone: ___________ - ______________________________
  21.  
  22. 7. FAX: ___________ - __________________________________
  23.  
  24. 8. E-Mail: _____________________________________________
  25.  
  26. A. I am primarily involved with: (Check one)
  27. ____ OEM Product Design  ____ R&D  ____ Production Machinery
  28. ____ Test Fixtures  ____ Other: ____________________________
  29.  
  30. B. The principle product produced at this location: ______________
  31. ________________________________________________________
  32.  
  33. C. I usually purchase small drive components from: _____________
  34. ________________________________________________________
  35.  
  36. D. I would like to have a company representative contact me: _____