Power Enquiry form

Contact Information
Name *:
Phone Number:
Production Requirements
What annual quantity do you expect to need?:
What is your target price for production units at this quantity? :
Desired prototype date
Desired production date
Custom Specifications
Select Type: AC DC
Input Voltage

Please Specify if Output is +, -, or isolated

Output 1

Volts *:

Output 2

Volts :
Amps :

Output 3

Volts :
Amps :

Output 4

Volts :
Amps :
Applications: Medical Industrial Commercial
Name *:
Phone Number:
Nominal Input Voltage:*
Input Voltage Range (e.g. 9-36VDC):
Output Voltage 1 (Volts):*
Output Current 1 (Amps):*
Output Voltage 2 (if required - Volts):
Output Current 2 (if required - Amps):
Output Voltage 3 (if required - Volts):
Output Current 3 (if required - Amps):
Name *:
Phone Number:
Estimated annual quantities *: (required)
Agency approvals required (UL, CE, etc.):
Preferred battery chemistry:
Manufacturer of cell (or TBD):
Nominal pack voltage *:
Nominal pack capacity:
Desired run time:
Expected cycle life:
Desired charge time:
Average discharge rate / duration:
Max / pulse discharge rate / duration:
Charge / discharge / storage temperature:
Humidity range:
Physical configuration of pack:
Maximum dimensions of battery pack:
Fuel gauge requirement: yes no
Battery low voltage cutoff mechanism within end product: yes no
Thermistor included: yes no
Maximum weight of battery pack:
Battery enclosure (enclosure, shrink wrap, etc.):
Output termination (connector, wire length, etc.):
If using an injection molded enclosure, do you require mechanical design assistance: yes no
Custom labeling requirements:
Other special requirements for the pack: