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Company Information

* Company Name: * Rep's Name:

Billing & Shipping Information

Billing
* Buyer Name:
* Address:
Suite #/Dept:
* City/Province:
* State:
* Zip/Postal Code:
* Telephone:
Buyer Email:
Shipping Same As Billing
* Specifier Name:
* Address:
Suite #/Dept:
* City/Province:
* State:
* Zip/Postal Code:
* Telephone:
* Specifer Email:

About the Application

Please describe function or task the
switch or sensor will perform.
If Switch: Will Directly Control Device
Will Signal Process State		 If Sensor: Voltage
Resistance
      (Desired Output Range)

Electrical Requirements: Describe the load to be switched

Current Type: AC    DC Circuit Type: Inductive    Resistive
Switch From: SPST    SPDT Switch Position: N/O    N/C
Circuit: Volts:
Watts: Amps:
Hertz:

Environmental Charactersitics

Medium: Contaminants:
Operating Temp (Highest): Operating Temp (Lowest):
Storage Temp (Highest): Storage Temp (Lowest):

Pressure Specifications

Input Pulsation: Yes
No		 Switch Mounting: Perpendicular To Gravity
Parallel To Gravity
Switch Type: Pressure
Vacuum
Differential		 Actuation Point:
(Show Units: IN/H20, PSI, PA)
Set For: Actuate     Deactuate
Pressure Limits - Proof: Pressure Limits - Burst:
Deadband Desired: Yes     No

Production Requirements

MPL Standard: 501     502     528
601     602     628
808     9370		 MPL Custom:
Current Client? Yes      No New Design? Yes           No
Is there a competitive part now in use? Yes           No
Competitor Name: Competitor Model/Part #:
EAU: Target Price:
Sample Now? Yes      Specify Quantity
No		 Ship To Specifier
Representative
Additional instructions:

Submission Instructions

     
1.) To submit this form now, please select "Submit" above.
2.) To reset this form please select "Reset" above.
3.) Once your form has been submitted an MPL Application Engineer will call to discuss your requirements.
4.) Based on your specification and estimated annual use, an MPL Application Engineer can quote prices, arrange for samples, and help you further refine your design objective.
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