Machinery Request More Information Form

If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact Würth Baer Supply Customer Service at 800-289-2237, and/or email bcustomerservice@wurthbaersupply.com.

Fields marked with an asterisk (*) are required.
Logged in customers may see parts of this form pre-filled with their information.

Step 1 – Business Information:

Your Job Title:

Your Full Name *:

Business Name:

Contact Phone *:

Contact Email:

Machine Name / SKU / Model:

I would Like:

some literature mailed to me
to purchase a manual for this product

Please send information on:

Step 2 – Address to Send Information:

Business Street Address 1:

Business Street Address 2:

Business City:

Business State:

Business Zip code:

Other Comments / Questions:

Submit