Information Request Logiball

INFORMATION REQUEST

Please fill in this form to request additional information about any of our products or to ask for a custom application.

I am interested in:

	Securimax Plugs		2001J Mainline Packers
	Large Flow-thru Plugs		Collapsible Mainline Packers
	Sleeve Installers		2001L Lateral Packers
	Fire Hydrant Flow Diffuser		Flexible Push-type Packer
	Logiplug		Other, please specify in comments

Comments:

*Name:
Title:
Company/Organization:
Address:
City:
State/Province:
Zip/Postal Code:
*Country:
*Email Address:
*Phone Number:
Fax Number:
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	Please keep me informed of new products

You may also contact us directly.

Canada:
440 Papin Street
Québec, QC G1P 3T9
Tel: 418-656-9767
Fax: 418-653-5746

USA:
21 Long Pond Rd
Jackman, ME 04945
Tel: 800-246-5988
Fax: 418-653-5746