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Engineering Request Form Please take a moment to fill out our brief survey so we can better serve you, General Information: Company Name *   Customer Name *   Email   Phone   Fax   Sales Rep format('m'); $day = $datetime->format('d'); $year = $datetime->format('Y'); $_POST['mm_due']=$month;$_POST['dd_due']=$day;$_POST['yy_due']=$year; ?>   Engineering Request Due Date   JMS Part # Inquiry Classification (check all that apply): > General Technical Assistance > Drawing Assistance / Review > Material Specification > Bid Technical Review > Other (please expain) <? echo(isset($_POST['other'])?htmlspecialchars($_POST['other']):'')?> Process Physical Characteristics:   Tnom (in Degrees Farenheit)   Tmax (in Degrees Farenheit)   Vibration (in g/Hz)   Pressure (in psi)   Vflow (in ft/sec) Chemical Environment: > Oxidizing > Reducing > Inert > Vacuum   Process Chemistry (5-31, 33, 34)   Electrical Classification (NEMA/IP Ratings, Isolated Intrinsically Safe Temperature Measurement Circuits, & Hazardous Locations) * Required field