Quotation Request Form

Please fill in the following information to request additional information about the specific product or for quotation regarding your current or upcoming application needs.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Name *

Title

Company

Email *

Phone *

Mailing Address *

Fax

Number of Zones to Control *

Max Number of Ampage or Heater Wattage *

Total system power draw (by adding amperage or heater wattage of each zone) *

Standard Length of Power Cable is 10 feet. How many feet are required?

Standard Length of Thermocouple Cable is 10 feet. How many feet are required?

Standard connectors are Contact (Epic series), but we can supply what you choose.

Fill in mold end connector specification. No. of Pins.

Fill in mold end connector specification. Amp Rating.

What type of Temperature Control Modules, or system do you need?: Additional Information (Please enter any specific information or comments that are not included in this form).

What is twelve plus 2? *