Polytron - Custom Products Quote Request

Contact Information

First Name: *

Last Name: *

Title:

Company: *

E-mail: *

Phone

Area Code Phone Number

Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Project and product details

Nom.

Min.

Max.

Input Voltage Range:

Filtered input?

Switching frequency:

Efficiency:

Outputs:

Output Voltage

Noise (mv P-P)

Output Current (mA)

#1 Voltage

#2 Voltage

#3 Voltage

Needed by:

Month Day Year

Isolation Voltage:

Vac Vdc

On/Off Control?

Case operating temperature range (C)

Min. Max.

W

L

H

Desired case size (inches):

Mounting:

Pin Chassis

Other Considerations or Comments (Include any pertinent information.)

Optimization Priority:

Please rate the most important to least important parameters to your application by placing a '1' next to the most important and proceeding down the list to the least important.

Rating

Quality

Size

Noise

Output Accuracy

Isolation

Input voltage range

Efficiency

Price

Other

Check all that apply:

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