Power Supply Catalog Request Form & Inquiry / Quotation Requests
Please check one:
Manufacturer
OEM
Distributor
Others
Company Name
Full Name
Address 1
Address 2
City
State
Zip Code
Country
Phone Number
Fax Number
E-Mail
How did you hear about us?
Application/End Use:
I am interested in :
Catalog
Sample
Quotation
Please fill in for Catalog, Sample or Quotation Request
Product Type
Wall Plug-in
Desktop
Open Frame
AC-AC
Unreg. DC
Regulated
Switchmode
NiCad/NiMH
Lead Acid/GC
Cordsets
Electronic Assemblies
GlobTek P/N
Customer P/N
Current Supplier Name
Current Supplier Part #
Current Supplier Price
Quantity
Target
Approvals required:
UL
CSA/cUL
TUV/VDE
CE
Other
Power Supplies Specifications
Input Volts
Hz
Output Volts/Amps
Input Config.
Output
Special Requirements: