Illumination Quote
Request Form
Company Name
First Name
Last Name
Address 1
Address 2
City
State Zip
Country
E-Mail Address
Telephone
Fax Number

Outside Diameter
Overall Length
Without Leads
Lead Length
Lead Type
Base Description
Volts Max Volts Min
Amps Max Amps Min
Color Temp Max Color Temp Min
Spectral Range nM
Light Output
Lamp Life Hours
Output Degradation
to Burnout
Spot Size
@ Distance
Alignment
Application:

Quantity required for Prototype Prototype Timing
Quantity required for Production Production Timing