Request for Quote Online Application : Emerging Power

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Company and Contact Information

Company:

Sales/Rep:

Address:

Project Name:

Project Contact: *

E-mail *

Phone: *

Website:

Product Information

Market Segment:

Reason for Request:

Application Notes

Application Notes:

Customer Specification

Mechanical:

Electrical:

Quotation Timeline

Est. Annual Quantity:

Target Price:

Need by Date:

Samples:

Qualification Timeline:

Production:

Battery Requirements

Chemistry:

Nominal Voltage Load:

Maximum Voltage:

Minimum Voltage Load:

Cut-Off Voltage:

Avg. Load Current:

Max. Load Current:

Load Duration:

Operating Temp. Range:

Storage Temp:

Expected Run Time:

Capacity: (Begin & EOL)

Cycle Life:

Usage:

Fuel Gauge:

Fuel Gauge Display:

Cell Balancing:

Thermistor:

Protection Circuit:

Secondary Protection:

Communication Protocol:

Other:

Battery Dimensions (Length x Width x Height/Thickness):

Connection Type:

Weight:

Case Material:

Charger Information

Type:

Method:

Time:

Max. Voltage:

Max. Current:

Termination:

Temperature Range:

Agency Approvals

ITAR:

UN/DOT:

UL Certifications

CE Certification:

ROHS:

Other:

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