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Company Name:
Company Address:
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Technical Contact:
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E-Mail (If Applicable):

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Overall Length of Control Needed:
Stroke length:
Compression Load:  
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blank.JPG (1905 bytes)Working:
Tension Load:  
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Temperature:  
blank.JPG (1905 bytes)Maximum:
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Type of equipment the control
will be used on and for what
purpose:
Life cycles required:
(Describe number of cycles per
minute, hour or day.)
Protection required against:  
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blank.JPG (1905 bytes)Dust
blank.JPG (1905 bytes)Corrosion
blank.JPG (1905 bytes)Other (Explain)
Quantity of controls:
Special instructions or other
requirements:
Approximate delivery date:

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