Sample Request Form

Order No.:

Customer/contact person:

Email contact person:

Date:

Tel-No.:

Endcustomer:

Demand:
K / Y
for:
years

Planned SOP:

Competition (Manufacturer):

Competition (Item):

Usage:
---Approval testPrototype testPromotional distribution

Application:
---Control EquipmentInverter/ConverterMeasuring InstTelecomPower supplyLightingTV Sat

Sector:
---AutomotiveIndustrialMedical

Special requirements (please cross if needed):
Thermocouple type K (standard)Measurement data

Delivery address: