Filter Selection Worksheet

* = Required

First Name*:

Last Name*:

Company*:

Title:

Address*:

Address 2:

City*:

State*:

Postal Code*:

Country:

Phone*:

Fax:

Your Email*:

This request is for:
Application adviceA quotation

This application is:
A new installationA replacementAdditional filtration application

Process Goals & Filtering Objectives:

If Replacement filter, are you using:
Filter BagsCartridge ElementsStrainer/Lined Baskets

Length (in):

Diameter (in):

How Many?

How often are you changing out your filter medium?