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TECHNICAL DATA/CATALOG REQUEST FORM:

Please provide the following contact information:

Name 	
Title 	
Company 	
Phone 	
FAX 	
E-mail 	
Web 	

Please enter Your technical data request in the box below: (Subject to availability.)

Are you already a current customer of IMS, Inc.?

No
Yes

Does your company currently purchase and/or use any products or services which IMS offers?:

No
Yes

If YES, what does your company currently use?

Wire
Cable
Tubing
Sleeving
Woven Cable
Wire Management Products
Cable Assemblies
Wire Harnesses
Cut/Stripped/Terminated Wire & Cable
Cut /Marked Tubing
Vendor Managed Inventory Programs

Do you wish to be added to our mailing list so we may send you information regarding product specials and product update information? 

NOTE: WE DO NOT SELL OR OTHERWISE PROVIDE ANY OF THIS INFORMATION TO ANY OTHER COMPANY.  THIS INFORMATION IS USED STRICTLY FOR YOUR OWN BENEFIT BY KEEPING YOU INFORMED OF THE LATEST PRODUCT INFORMATION BY IMS & IT'S AFFILIATED COMPANIES.

No
Yes

How did you hear about IMS?

Current Customer
Link from an IMS Supplier
Internet Search
Electronic Source Book
Thomas Regional
Subliminal Message/Inner Voices
Other