Thermostat Inquiry

Fields marked in orange are required fields.

Name
Company Name
Address
City, State, Zip
Telephone
Email
On what type of device will Thermostat be used?
Is Thermostat to control temperature of	Metal-Surface Metal-Internal Air Liquid Gas Other:
Estimated Daily Use of Device in Hours
Quantity to be ordered at one time
Estimated Yearly Requirements
Desired Method of Mounting
Electrical Requirements:
Load	Watts
Current	Amps
Resistive/Inductive	Resistive Inductive
Voltage	Volts AC DC
Remarks
Temperature Requirements:
Setting Calibrated at	°F °C
Adjustable between	°F °C AND °F °C
Tolerance (+/- )	°F °C
Allowable temperature differential between make and break of contacts	°F °C
Contacts	Open Close on temperature rise
Remarks
Is a model of your unit being sent to us under separate cover?	Yes No
Location of Thermostat
Available Space for Thermostat
Area to be Controlled
Location of Heating Element
Comment (Be as specific as possible to insure a quick response)