Salutation: |
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First Name(s): |
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Last Name: |
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Job Title / Departement: |
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Company: |
(required, if private - please
write
"PRIVATE") |
Street / P.O. Box: |
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City: |
State:
Zip: |
Country: |
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Phone Number: |
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2nd Number: |
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FAX Number: |
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Email Address: |
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Subject / Interest: |
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(required, e.g.
DC/DC Converter SDC144.1) |
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Quantity needed: |
(e.g. 250 units per year) |
Project Schedule: |
(e.g. in 1 week 3 prototypes
needed,
then 20 units per week) |
Application: |
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(e.g. power-supply
for radio on a forklift truck) |
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Input
Voltage Range: |
(e.g. 16 to 36VDC) |
Output Voltage(s)
and Current(s): |
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(e.g. 12.5VDC /
12A max.) |
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Galvanic Isolation |
between Input and Output |
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Letter / Comments: |
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