Complete all required areas (*) as well as pertinent optional information in order to register.
Customer Information
* First Name
* Last Name
  Job Title
* Address
* City
* Phone Number
  Fax Number
* E-mail
  Primary Product(s) Produced
* Industry Served
* Where Do You Purchase Bearings Today?
  Do You Currently Use Sealmaster Bearings?
* Do You Currently Use Power Transmission Solutions Products?

Equipment Information
* Application Name / Description
* Machine Producer
* Machine Model Number
* When was Machine Installed?
* Number of Machines per Plant
* Number of Employees Required to Change Bearings
Current Bearing Information
* Current Bearing Part Number
* Average Bearing Life
* Target Bearing Life
  Do You Have a Failed Bearing You can Return for Our Analysis?
Application Information
  Shaft Speed (RPM)
  Radial (lbs)
  Axial Load (lbs)
  Shock/Impact Loads
  If Yes, Explain
  Fast Acceleration/Decelaration
  If Yes, Explain
  Ambient Temperature (°F)
  Bearing Operation Temperature (°F)
  Contamination Information (wet, dry, types of particles or corrosives)
* Direct or Belt Drive
Problem Summary
* Problem Summary
* What Has Been Done in the Past to Improve Life?
* When Do You Expect to Change Bearings Again?
  Have You Selected a Sealmaster Bearing Option? If Yes, What?
  Other Comments?

* required fields