WinField United Spray Tip & Tissue Sample ProgramPlease enable JavaScript in your browser to complete this form.Dealer Information - Step 1 of 2Dealer Business Name *Dealer Contact PersonDate of Clinic *EmailPhoneDealer CityDealer StateALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYNextGrower Business Name *Grower Contact PersonWinField United Intended Product Purchase *Select OneAccudropClass Act RidionClass Act NGInterlockMax-In for BeansMax-In MangnesiumMax-In Ultra MangnesiumMax-In Ultra ZMBMax-In Boron 8%Max-In Ultra Mangnesium FourMax-In SulfurMax-In CalciumMax-In Vine and VegMax-In Cotton NFMax-in Copper 5%Max-In ZincMax-in Iron 5%MasterlockOnTargetUltra-LiteSpray Tip ProgramYesNoSpray Tip Brand1/4 TTJ04 Turf Jet1/4 TTJ08 Turf JetABJ11004ABJ11006AIUB TeejetAIUB Teejet low volumeHypro ULD120-03Hypro ULD120-04Hypro ULD120-05Hypro ULD120-06Lechler ID 110-03Lechler ID 110-04Lechler ID 110-05Lechler ID 80-04PSLDMQ2006PSLDMQ2008PSLDMQ3004PSLDMQ3005PSLDMQ3006PSLDMQ3008QCTF Turbo FloodjetTADF025-DTADF03-DTADF04-DTADF05-DTADF06-DTASF03-DTASF06-DTDXL 025-DTDXL 110025-DTDXL 11002-DTDXL 11003TDXL 11003-DTDXL 11004TDXL 11004-DTDXL 11005TDXL 11005-DTDXL 11006TDXL 11006-DTDXL 11008TDXL 11008-DTeejet 1 1003VP-CTeejet 1 1004VP-CTeejet 1 1005VP-CTeejet 1 1006VP-CTeejet AI 11003Teejet AI 8003Teejet AI 8005TeeJet AI11002TeeJet AI11003TeeJet AI11004TeeJet AI11005TeeJet AI11006TeeJet AI11008TeeJet AI11025Teejet AITTJ60-110008VP-CTeejet AITTJ60-110010VP-CTeejet AITTJ60-110015VP-CTeejet AITTJ60-110025VP-CTeejet AITTJ60-11002VP-CTeejet AITTJ60-11003VP-CTeejet AITTJ60-11004VP-CTeejet AITTJ60-11005VP-CTeejet AITTJ60-11006VP-CTeejet AIXR 110015 (100)Teejet AIXR 11002 (50)Teejet AIXR 110025 (50)Teejet AIXR 11003 (50)Teejet AIXR 11004 (50)Teejet AIXR 11005 (50)Teejet AIXR 11006 (50)Teejet StreamJet (3 Orifice)Teejet StreamJet (7 Orifice)Teejet StreamJet (Single Orifice)Teejet TTI 1 1003-VP-CETeejet TTI 1 1004-VP-CETeejet TTI 1 1005-VP-CETeejet TTI 1 1006-VP-CETeejet TTI11001Teejet TTI110015Teejet TTI11002Teejet TTI110025Teejet TTI11003Teejet TTI11004Teejet TTI11005Teejet TTI11006Teejet TTI11008Teejet TTI11010Teejet TTI11012Teejet TTI60-110025VPTeejet TTI60-11002VPTeejet TTI60-11003VPTeejet TTI60-11004VPTeejet TTI60-11005VPTeejet TTI60-11006VPTeejet TTI60-11008VPTeejet TTJ60-110010Teejet TTJ60-11002Teejet TTJ60-110025Teejet TTJ60-11003Teejet TTJ60-11003VP-CETeejet TTJ60-11004Teejet TTJ60-11004VP-CETeejet TTJ60-11005Teejet TTJ60-11005VP-CETeejet TTJ60-11006Teejet TTJ60-11006VP-CETeejet TTJ60-11008Teejet XRC 110025Teejet XRC 11003Teejet XRC 11003-VPTeejet XRC 11004Teejet XRC 11004-VPTeejet XRC 11005Teejet XRC 11005-VPTeejet XRC 11006Teejet XRC 11006-VPTeejet XRC 11008Teejet XRC 11010Teejet XRC 11015Teejet XRC 11020Teejet XRC 80015Teejet XRC 8002Teejet XRC 8003Teejet XRC 8004Teejet XRC 8005Teejet XRC 8006Teejet XRC 8008Wilger DR110-10Wilger MR11006Wilger MR11008Wilger MR11010Wilger UR110-05Wilger UR110-06Wilger UR110-08Wilger UR110-10Spray Tip Quantity3672Tissue Sample ProgramYesNoTissue Sample Quantity510EmailPhoneShip-to AddressAddress Line 1Address Line 2CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDo you have any additional comments?NoYesAdditional CommentsPreviousCommentSubmit WinField United Clinics Program Terms & Conditions Download
