Survey Form

LET OUR EXPERTS RECOMMEND THE RIGHT LIGHT FOR YOU!
Just fill out this form for each light you need, fax it to 1-888-533-5669, to receive a recommendation from our experts.

 
Name:
Title: 
Department:
Company:
Address:
City: State: Zip:
Country:
Phone:    Fax : 
E-mail:
A.  I need a light that does this: 
  • Lamp type 
  • Enter lamp number here 
B. I will need approximately  lights
I am still in the developmental stage and am just gathering information.
C. Delivery will be required within  weeks. 
D. Power source to be used (choose from power
source types below 1,2,3, 4 or 5)
1. Batteries to be contained within the light?
 No 
Yes
    • Should batteries be rechargeable? 
 No
Yes
    • Should a recharger be contained within the light?
 No
Yes
2. I have line power at  voltage.
3. I have vehicular power at  voltage.
4. I have solar power in place at  voltage.
5. I want a complete assembly including a solar panel, and rechargeable battery.
E. Efficiency:
F. Beam type:
G. Beam shape:
(circular beam) concentrated spot for highest intensity. 
(elliptical beam) elongated in one direction for medium intensity with some spread.
(rectangular beam) rectangular for maximum spread of light. 
H. Beam color: 
I. Beam mode: 

       Rate of flash per minute 
      (if flashing operation)
J. Switch type: 
K. Time of day light will be operating: 
L. Use duration: Light will be operating each day for
hours?
M. Toughness of unit:
1. Light subject to substantial abuse or vandalism.
2. Light must be tough, but will not be deliberately
abused.
3. No unusual abuse.
N. Is the light to be permanently mounted?
  • If so, mounted where? 
 No
Yes
O. Is the light to be hand carried like a flashlight? No
Yes
P. Location of light? 
Q. Water resistance: 
Submergible to feet.
R. Is the light to be used near explosive liquids or gasses?  No
Yes
S. Is there a government or industry specification that must be met?
  • Agency in charge: 
  • Number(s) of specification 
 No
Yes
Thank You!
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