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Phoscrete Trade Shows Quick Response Form
Required Required Question(s)
Required 1.

What is your department's involvement with Concrete Repair? (check all that apply)
Concrete repair is often a part of our maintenance projects.
We have staff that performs concrete repairs in our district.
We hire contractors for concrete repair projects.
We have no involvement with concrete repair.
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  • 500 characters left.
Required 2.

How do you feel about your department's success with concrete repair products? (check all that apply)
We are very satisfied with the concrete repair products we use today
We have problems with shrinkage and cracking in partial depth repairs.
We are open to trying new materials to solve our repair problems.
We are restricted by the QPL on repair materials we are allowed to use.
  • Comment:

  • 500 characters left.
Required 3.

How can we best communicate with you in the future? (check all that apply)
Please telephone me to discuss a current project I have.
Please telephone me to discuss a project you have in my area.
Please follow up with me on a specific date regarding a future project (enter date below)
Please subscribe me to "The Phoscrete Fix", your quarterly email newsletter.
Do not contact me, I will call you whan I'm ready to learn more about Phoscrete
Contact my colleague (provide name, title, phone and email below)
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  • 500 characters left.
Required 4.

Please verify all contact information below that was missing or incorrect in our mailing to you. All fields are required.

We will only follow up with you in the manner you specify in question 3 above.

We do not share your personal information with any third party.

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