Power Supply
Request Form

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

Input Voltage: AC
DC

  Voltage Current Accuracy
Output #1 Min. Max. Peak %
Output #2 Min. Max. Peak %
Output #3 Min. Max. Peak %
Output #4 Min. Max. Peak %
Output #5 Min. Max. Peak %
Output #6 Min. Max. Peak %
Total Power: Continuous:
Peak: /Duration:
Temperature: Operating:
Storage:
Mechanical: Open Frame Enclosed Rack Mount
Desktop PCB Mountable
Safety Agencies UL1950 UL2601 CSA C22.2
IEC 950 TUV CE (LVD)
Other:
Target Price:
Other Information:
Quantity required for Prototype Prototype Timing
Quantity required for Production Production Timing