Vial Sales Request for Quotation Form Fill out the online form below or print a copy of the form and send it by email (firstname.lastname@example.org) or fax (+1.856.691.4525) Information You Need to Get the Order! Company*Contact Name* Address*Email* Phone*How did you hear about us?*Google (or other major search engine?)ReferralSPECIFICATIONS:Drawing Available Drawing Available Drawing UploadSamples Available Samples Available Glass Type:*Type 1 ClearType 1 AmberOD (6 mm up to 35mm)*Length (12mm up to 178mm)*Decorated:*YesNoWall Weight (0.70 up to 2.8mm)*Bottom:*FlatRoundFill Capacity (.5mL up to 100mL)** A container and its corresponding cap must have matching finishes.Cap:*MetalPlasticLinedUnlinedLining MaterialLining Material*Measure from one side of the inner wall to the opposite side to determin cap diameter. Calculate a bottle's neck finish by measuring the diameter of the outermost threads. Then, see how many times the threads pass one another to determine the finish. (ex. 20 mm dimension with 1.5 thread turns = 20/410 neck finish). *A container and its corresponding cap must have matching finishes. Common Neck Finish:*400410415425BUDGET:*QUANTITIES:*END USE APPLICATION:*Quality plan or special considerations:*Additional comments:PACKAGING:* Shrink Wrap Modules Tray Pack Cell Pack Carton Palletized CAPTCHA This iframe contains the logic required to handle AJAX powered Gravity Forms.