Switches

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General Information
Name *		Required Feilds (*)
Title
Company *
Address
City
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Telephone *	ex 616-555-1212
Fax	ex 616-555-1212
Email *

Electrical Data ( Switch Contacts ):
Current ( amps )				Voltage
	Lamp				AC		Hz
	Resistive				DC
	Inductive
Motor        Inrush       Stalled Rotor        Running     Circuit ------------------ SPST N.O. SPST N.C. SPDT DPDT 3PST 3PDT 4PST 4PDT Other
	Other

Environmental Data
Vibration		Hz	at		g's
Shock		g's	at		duration		Life Cycles
Insulation Resistance					milliohms	at	VDC
Ambient		to		° F	Operating
Ambient		to		° F	Non-operating

Envelope
	Toggle Switch				Pushbutton Switch
	Toggle Lever Lock				Switch Guard
	Size				Weight		ounces
Termination:		(mil spec)			Other
Pigtails:		Type wire			Terminals (Type)

Applicable Specifications

Program / Application

Production Requirements

Estimated production target price
Prototype quantity
Production quantities per year
New requirement		Firm requirement

Description of installation and/or type of equipment the switch will be mounted on