Last Name *:

First Name *:

Company:

Departement:

Street:

ZIP - Place:

Country:
-----ArgentinaAustraliaAustriaBahamasBahrainBelgiumBermudaBrazilCayman IslandsChannel IslandsChileChinaColumbiaCyprusCzech RepublicDenmarkEgyptEstoniaFinlandFranceGibraltarGreeceGuernseyHong KongHungaryIndiaIndonesiaIraqIranIrelandIcelandIsle of ManIsraelItalyJerseyJordanKoreaKuwaitLebanonLibyaLichtensteinLuxembourgMacaoMalaysiaMaltaMexicoMonacoNew ZealandNetherlandsNigeriaNorwayOmanPanamaPeruPhilippinesPolandPortugalQatarRussiaSaudi ArabiaSwedenSwitzerlandSingaporeSpainSouth AfricaSyriaSwitzerlandTaiwanThailandTurkeyUkraineUnited Arab EmiratesUruguayUzbekistanVenezuelaYemenOther

Phone:

Fax:

E-Mail *:

Area of Application:
GeneralTextilePlasticsPaper printingThermoformingAutomotiveOther area

If other area:

We request a quotation for the following application:

Objective/purpose of the IR application:

Working width (mm):

Length in direction of travel (mm):

Desired IR output (kW):

Output currently used (kW):

Available electrical supply:

Voltage (Hz):

No. of control zones in the electronic control:

Additional remarks: