Sculpt Survey If you are interested in seeing a prototype please fill out the form below. Date* MM slash DD slash YYYY Name* First Last Company* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Preferred Phone*How did you hear about YUPO® Sculpt™?* YUPO® Sculpt™ Sample Bottle Trade Show Ad Referral E-mail If you heard about Sculpt™ from a trade show, please indicate which show it was. Select all that apply.* Pack Expo Fuse Packaging That Sells GOA Sustainability in Packaging Label Expo Petroleum Packaging Council DSCOOP HiddenIf you heard about Sculpt™ from a trade show, please indicate which show it was. Select all that apply. Pack Expo Fuse Packaging That Sells GOA Sustainability in Packaging Label Expo Petroleum Packaging Council DSCOOP Other If Other please specify Who are your key supply chain partners?Printer Brand Owner Molder Package Designer What is the product?* What is the vertical market?* Household Personal Care Health & Beauty Industrial Other If Other please specify What type of resin is being used for your application?* High Density Polyethelyne (HDPE) Polypropylene (PP) Polyethelyne (PET) TBD Other If Other please specify What type of container / part?* Bottles Tubs Parts TBD Other If Other please specify What type of IML substrate are you interested in?* Clear Opaque TBD Other If Other please specify Is the molder presently equipped to place labels automatically into the mold?* Yes No TBD What is the print process for this project?* Offset Flexographic Gravure Digital TBD Other If Other please specify What is the Market segment?* Consumer Packaging Goods Durable Goods TBD Other If Other please specify What is the classification of this project?* New IML Project Competitive alternative to existing supply chain Other If Other please specify What is volume of containers or parts / year?* Less than 1 million 1 - 5 million 5 million + TBD What is the expected time frame for this project to go commercial?* Within 6 months 6 months to 1 year TBD Additional comments (please indicate here if you want additional samples)
