| | |
|
Fields shown with * are required. |
|
Click here for a printable form (pdf)
|
| |
|
| Name:* |
|
| Company:* |
|
| Industry:* |
|
| Title & Department: |
|
| Street Address: |
|
| City:* |
|
| State/Province (US & Canada): |
|
| Zip / Postal Code: |
|
| Country: |
|
| Email:* |
|
| Phone:* |
|
| Fax: |
|
Distributor/Representative:
(if applicable) |
|
|
Application Information:
(Product or machine description) |
|
| Load: |
lbs |
N |
| Velocity: |
in/s |
m/s |
| Stroke / Travel Length |
in |
m |
| Acceleration / Deceleration |
in/s^2 |
m/s^2 |
| Linear Accuracy: |
in/ft |
mm/m |
| Temperature: |
°F |
°C |
| Repeatability: |
in |
m |
| Environment: |
|
|
| Drive Mechanism: |
|
|
| Wheel Plate Options: |
|
|
| System Mounting Configuration: |
|
|
Applied Load Information /
Free Body Diagram (FBD)
|
|
|
Motion Profile:
|
|
|
Duty Cycle:
(Describe application of force, F, during motion, e.g.-cyclical/sinusoidal, etc) |
|
| Life Requirements: |
|
Additional Notes:
(Other pertinent information, delivery quantities and schedule, target price) |
|
|
|