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Contact Name________________________________
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Phone______________________________________
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Email ______________________________________
If choose (a), (b) or (c), you can skip question 5 and continue on from question 6.
5.
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(b) Are these final products to be used in commercial applications or military applications?
(c) Which countries do you plan to distribute your final products to?
7. If you are a contracted fabricator, a fabricator for contract manufacturer, or a trading company representing either,
please state your product, name the OEM, your contact information at OEM, and the program where Rogers products are
designed-in.