To compete a request for a custom product, please fill out and submit the following form. (blue denotes required fields)  

Name
 
 
Title
 
Company
 
SIC#
 
Business Type
 
Telephone
 
 ext.
Fax  
Email  
Confirm Email
 
Type of sensor/switch
to be used with
 
Brand  
Part number
 
Description and/or
background
(explain problem(s),
required feature(s),
environment, etc.)
 
Desired material(s)
of construction:
 
   

Would you like us to provide a quote for a sample? Yes No
 


There is a standard 2 to 3 week evaluation and processing time for
all CPRs. To help us better serve you, please estimate the following:

 
Conceptual solution(s) needed by: Insert Date
 
(Date must be in mm/dd/yyyy format.)
Targeted Implementation: Insert Date
 
(Date must be in mm/dd/yyyy format.)

 
Upload sketch of application: optional
 

 
Custom Supplied Material (CSM)
Are you supplying SoftNoze sample parts, drawings, etc.?
Yes No
 

 
Quoting Data Quantity Required
 

 
One time order
Repeat requirements;
estimated annual usage:
 

 

Is project budgeted? Yes No Unsure

 

 
Target Unit Price (optional): $