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Heater Application Request
1)  What supply voltage is available?  
2)  What type of control action do you need?  
3)  What is the temperature range of the limit application?
°F   and/or   °C Low temperature
°F    and/or   °C High temperature
Don't know
4)  What type of sensor do you intend to use?
Thermocouple,   Type 
RTD   
Other 
Don't know
5)  What type of output do you need?
6)  Does your application require an agency approved limit controller?
Yes, please specify: 
No
7)  Do you intend to use process (4-20mA(DC) / 0-5V(VDC)) outputs?   
8)  Do you need alarm or secondary outputs?      
9)  Do you need communication capability?      
10)  Are there any specific mounting size/package requirements?
1/32 DIN
1/16 DIN
1/8 DIN
1/4 DIN
Sub-panel mount
High ambient temperature
Dust/dirt
Explosive environment
Corrosive environment
NEMA 4X/IP65
11)  Please provide a brief application description:
12)  Are there any unique application considerations? If so, please describe:
     (e.g. limited space, corrosive/erosive/explosive environment, packaging/housing)
13)  Will you require any other thermal systems components?
Heaters
Sensors
Temperature controllers
Power controllers
  Contact Information:   ( = Required Input)
First Name:  
Last Name:  
Company:  
Title:  
Industry:  
  If "Other" Please Specify:  
 
Address:  
 
  City: Postcode: Country:
 
  Telephone: Extension: Fax:  
   
E-mail:  
Comments:  

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