Static Discharge Brush Order Form

Static Discharge Brush Order Form
Please complete this form to order static discharge brushes. Provide detailed order and shipping information to ensure accurate processing.
Company Name
Contact Person Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Shipping Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Select Static Discharge Brush Type
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Standard Static Discharge Brush
General-purpose static discharge brush for electronics and cleanroom use.
$22.50QuantityBristle MaterialHandle Type

ESD-Safe Precision Brush
Fine-tip brush for delicate static-sensitive applications.
$28.00QuantityBristle Length

Custom Static Discharge Brush
Specify custom dimensions, bristle type, or handle requirements.
$35.00QuantityCustomization Level

Total
$0.00
Intended Application or Use Case
Requested Delivery Date
MonthDayYear
Date
Purchase Order Number (if applicable)
Special Instructions or Notes
Upload Specification Sheet or Drawing (optional)
Cancelof
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