INQUIRY REQUEST FORM

Corporate Headquarters

23181 Antonio Parkway

Rancho Santa Margarita, CA 92688  USA

Tel: (949) 766-9240,   Fax: (949) 766-9241

Email: Sales@fspgroup.us     Website: http://www.fspgroup.com

 

   YOUR REQUIREMENTS

Please fill in this form with as much info as possible pertaining to your requirements.

Submitting this form automatically contacts our Sales Department with your request.

We will contact you by email or telephone as soon as possible.

 

Your Name, Title:

Company:

Address:

Telephone:

Email Address:

 

Questions:

If you have a question concerning a product or requirements, please enter here.

 

Please provide the following details of your requirements:

 

Type of Power Supply (check/select all that apply):

AC to DC     DC to AC Inverter     DC to DC Converter     PC:    Custom Design

 

Application / Usage: (check all that apply)

Open-Frame, component within a system          External component, stand-alone source

 Medical Application                                             Other: 

 

Total Overall Max Continuous Power required:

 Watts Total

 

Number of individual power outputs required:

 

Specifications for each output:

 

 

Ouput No.

Voltage

Current

+Tolerance

-Tolerance

Power(Watts)

1

[V]

[A]

[+ %]

[- %]

[W]

2

[V]

[A]

[+ %]

[- %]

[W]

3

[V]

[A]

[+ %]

[- %]

[W]

4

[V]

[A]

[+ %]

[- %]

[W]

5

[V]

[A]

[+ %]

[- %]

[W]

 

Special signals, LEDs, or controls required: (check all that apply)

Adjustability,      DC-OK monitor,      Remote ON/OFF,     LED indicators

 Other: 

 

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