Laser Diode Products for the OEM - Power Technology, Inc.
Laser Diode Products for the OEM - Power Technology, Inc.
Laser Diode Products for the OEM - Power Technology, Inc.
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tocopy this page, fill in <strong>the</strong> necessary<br />
in<strong>for</strong>mation, and fax it to us at 501-407-<br />
(Check all that apply.)<br />
I am interested in <strong>the</strong> following wavelengths.<br />
� 266-355nm � 370-450nm<br />
� 532nm � 630-690nm<br />
� 745-980nm � 1000-1400nm<br />
� above 1400nm<br />
� specific wavelength(s)<br />
I need output power<br />
� below 5mW � 5-10mW<br />
� 15-35mW � 40-100mW<br />
� 150-500mW � 1000mW or above<br />
� specific power level(s)<br />
I am interested in <strong>the</strong> following options.<br />
� circular beam<br />
� temperature control<br />
� fiber optic delivery<br />
� computer control<br />
� line generating optics<br />
� o<strong>the</strong>r<br />
I currently work in<br />
� <strong>OEM</strong> manufacturing<br />
� product development <strong>for</strong> emerging<br />
application(s)<br />
� research/university setting<br />
� o<strong>the</strong>r<br />
For<br />
medium<br />
to high<br />
quantity<br />
orders<br />
GENERAL INFORMATION<br />
Custom <strong>Laser</strong><br />
Request Form<br />
0036. One of our sales engineers will contact you promptly<br />
with ideas and quotations <strong>for</strong> <strong>the</strong> ideal laser product <strong>for</strong><br />
your application.<br />
I have <strong>the</strong> following custom product requirements. (If necessary,<br />
please fax us a drawing.)<br />
My application is<br />
I’m also interested in<br />
Additional comments<br />
Name<br />
Company/Organization<br />
Address<br />
City<br />
State Zip<br />
Country<br />
Phone Ext.<br />
Fax<br />
Email<br />
PH 501.407.0712 / FAX 501.407.0036 / sAles@<strong>Power</strong>tecHnology.com / www.<strong>Power</strong>tecHnology.com<br />
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