injection molding, injection molding parts, custom plastic parts, injection molded parts, insert molded parts, insert molding

Injection Molding or Insert Molding Quote Request Form

H & S Specialties Inc,

P. O. BOX 32152

PHONE 763-792-2184       TOLL FREE 877-562-5070 
FAX 763-785-9065 Toll Free Fax 877-280-2087

Demographic Information

Company Name (required field)

Your Name (required field)

Address (required field)


City (required field)

State (required field)

Zip (required field)

Phone Number (required field)

Extension Number

Fax Number

Email Address (required)

Part Information

Part Name

Part Number (required field)

Revision Level

Requested Delivery Date (00-00-00) (required field)

Print Available (attach file below)

Sample Available

Type of Material (required field)

Annual Quantity

Quantities You Want Quoted (separate by commas) (required field)

Target Price

Additional Information

RFQ Number

RFQ Close Date

Engineers Name

Engineers Phone Number and Extension


Please attach files here.

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