* indicates a required field

New or Existing Customer?

Requested By

Title
First Name
Last Name
Email
Telephone
Company
Salesperson
(Please enter the name of your Sekisui salesperson or the authorized Selvol distributor you are working with for this project. Please leave blank if you do not have a contact yet.)
Additional Confirmation Email
(Addtional email to send the request confirmation to. Confirmation will automatically be sent to the Requested By Email above.)

Deliver To

Title
First Name
Last Name
Email
(If different than requestor's)
Telephone
Company
Address
Address 2
City
State/Province
(US residents use 2 letter
abbreviation)
Zip/Postal Code
Country
Annual Consumption
Requirement
FED-EX / UPS Number
Special Shipping Instructions

Sample Selection
(required)

You may select a total of three different grades between the product lines listed. Please click on the Grade Type to request samples of that type.

Selvol™ GRADES


Super Hydrolyzed
Fully Hydrolyzed
Intermediate Hydrolyzed
Partially Hydrolyzed
Polymerization Grades
Fine Particle Size Grades
Tackified Grades
Warp-Size Grades
Solution Grades

Note: All viscosities are measured at 4% aqueous solution at 20 degrees Celcius except SELVOL™ MM-51 (10% aqueous solution at 25 degrees Celcius)


Premiol™ GRADES


Deep Well Cementing
Mid-range Cementing
Off-shore Cementing

Ultalux™ GRADES


Personal Care

If the sample you are requesting is not listed please use the Unlisted Sample box below
Unlisted Sample

End-Use Application

Adhesives
Paper
Specialty
Building Products
Textile
Personal Care
Other

*Note: Sekisui Specialty Chemicals will not sell or sample SELVOL™ Polyvinyl Alcohol PVOH for applications that involve ingestion or contact with human mucous membranes.

Please describe anticipated PVOH benefits in the application and any questions so Sekisui Specialty Chemicals can ensure proper grade selection and provide effective follow-up.

   

Other Information

Please indicate when you expect to complete trials with your SELVOL™ Polyvinyl Alcohol sample(s):

How did you hear about Selvol PVOH?


If Other:

Validation Code

Enter the above code here:
 
Can't read? Try different words.

Thank you for taking the time to complete this form. Please ensure all fields have been completed prior to clicking the "Send" button.