Company Name:

Contact Name:

Phone:

Fax:

Email:

Are you interested in sensors? YES NO

Sensor Type:

Initial Volume:

Ultimate Volume:

Required Measurement Range:

Required Measurement Bandwidth:

Required Measurement Resolution:

Application Description:

Are you interested in a data acquisition system? YES NO

Measurement Parameters (i.e. Pressure, Temp, etc.):

Steady-Stateor Transient Input Signal):

Number of Sensing Points Required:

Required Measurement Range:

Required Measurement Bandwidth:

Required Measurement Resolution:

Do you have Existing Sensors that you wish to interface with? YES NO

Manufacturer/Model #: /

Mechanical Interface Requirements (Sensor Packaging, Mounting, Connector):

Wired or Wireless Interface?

RF Transmission Distance Required:

RF Operating Environment (i.e. Line of sight? Outdoors?):

PC or Handheld Interface Required:

Monitoring Parameters/Features:

Data Acquisition Duty Cycle:

Application Description: