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Aluminum Extrusion
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Name
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First
Last
Email
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Company Name
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Application Name
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Application Description
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Metric to be Improved
Timeline
Manipulated Object
Size (LxWxH)
Weight
Will the system be communicating to other system components?
*
Yes
No
If Yes to above, relevant communication protocol information must be sent
Number of Input Devices
List the Input Devices
Number of Output Devices
List the Output Devices
Power
120VAC – Single Phase
220VAC – Single Phase
240VAC – 3-Phase
480VAC – 3-Phase
Pneumatic Airline
Space Constriants
Special Considerations
None
Food Grade
Washdown
Pharmaceutical Grade
Collaborative
Other
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