Industrial Lamp
Quote Request Form

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

Enter make and
part number if known
Make of the Lamp
Lamp Part Number

If you do not know the make and part number
or need a special lamp please
fill out any required parameters on the form below:

Custom Lamp Info

Lamp Type Envelope

UVlampwp.GIF

Arc Length (A) Overall Length (B) Diameter (C)
Left Lead Length Right Lead Length

Fitting Style

-2S -3S -4C -5C -6C

Lamp Specs


Watts inch/cm


Lamp Wattage


Lamp Amperage
Open Circuit Volts


Operating Volts


Lamp Serial Number
Quantity required for Prototype Prototype Timing
Quantity required for Production Production Timing