*Contact Name:

Company:

*Address:

*City:

*State:

*ZIP:

*Phone (+area code and ext.):

Fax:

Email:

Website:

*Date:

*Switch Application:
Please explain how the switch will be used in your application.

Sample Required: Yes No

ELECTRICAL:

Volts:

Current Type:

AC DC

Amps:

Circuit Type:

Inductive Resistive

Contacts:

Terminal Size Preference:

SPST SPDT Normally Open Normally Closed

3/16" 1/4" PCB Other"

Required Life:

SWITCHING MEDIUM:

Type:

Set Point:

Pressure Vacuum Differential

Medium:

Set Point Tolerance: (ex: ±20%)

Contaminants present: Yes No

Set on:

Increasing Pressure / Vac.
Decreasing Pressure / Vac.

Desired Deadband:

Max System Pressure:

Port Configuration: (see catalog)

Input Pressure Pulsation?:

Yes No

ENVIRONMENTAL:

Temperature: °F °C

Typical Operating Temperature:

Min:

Max:

Switch (Diaphragm) Orientation:

High Vibration Environment?:

Vertical Horizontal

Yes No

Humid Environment?:

Required Agency Approvals:

Yes No

UL CSA FDA None

Requested Ship Date:

Estimated Annual Volume:

Target Price:

Current Supplier:

Comments: