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4) Signature _________________________________________________________ Date: ________________________
5) Please tell us about your company:
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6) What is your primary job function responsibility? (Check one)
Corporate Executives (B) Product Design/
Manufacturing Production
R&D Personnel (I)
Management (C)
Purchasing (L)
Manufacturing Production Marketing & Sales,
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Management (P)
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7) How is THIS LOCATION involved in the gear industry?
(Check all that apply)
WE MAKE GEARS (or Splines, Sprockets, Worms, etc.) (20)
WE BUY GEARS (or Splines, Sprockets, Worms, etc.) (22)
WE SELL NEW MACHINES, TOOLING OR SUPPLIES TO GEAR
MANUFACTURERS (24)
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WE provide SERVICES to gear manufacturers (25)
(please describe) ____________________________________________
WE distribute gears or gear products (including agents and sales reps. (26)
WE are a USED MACHINE TOOL dealer (30)
Other (please describe) ___________________________________ (32)
8) Which of the following products and services do you personally
specify, recommend or purchase? (Check all that apply)
Machine Tools
Gear Hobbing Machines (50)
Gear Shaping Machines (51)
Gear Shaving Machines (52)
Gear Honing Machines (53)
Gear Grinding Machines (54)
Gear Inspection Equipment (55)
Bevel Gear Machines (56)
Gear/Spline Roll-Forming
Equipment (57)
Broaching Machines (58)
Heat Treat Equipment (59)
Deburring Equipment (60)
Non-Gear Machine Tools
Turning, Milling, etc.) (61)
(Please print e-mail address)
Tooling & Supplies
Functional Gages (62)
Workholding (63)
Toolholding (64)
Cutting Tools (65)
Grinding Wheels (66)
Gear Blanks (67)
Lubricants/Cutting
Fluids (77)
Service & Software
Heat Treat Services (69)
Gear Consulting (70)
Tool Coating (71)
Tool Sharpening (72)
Gear Design Software (73)
Gear Manufacturing
Software (74)
Power Transmission
Components
Gears (75)
Gear Drives (76)
Bearings (78)
Motors (79)
9) What is the principal product manufactured or service performed at THIS LOCATION?
10) How many employees are at THIS LOCATION (Check one)
1-19 20-49 50-99 100-499 500+
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