Required fields
  Name
 Title
  Company
Email
  Phone
 Fax
  Address
  Reflector Details:
 
1. Is this a request for a reflector design?
Yes No
2. What is the application?
Indoor Outdoor Automotive Other
If other, please explain
3. Do you have any material preferences?
Yes No
If yes, please explain
4. Are there any tooling restrictions?
Yes No
If yes, please explain
5. Will the reflector be?
Extruded Segmented Other
If other, please explain
6. How do you plan to manufacturer the reflector?
Hydroform Spinning Other
If other, please explain
  Lens Details:
 
7. Is this a request for a lens design?
Yes No
8. What is the application?
Indoor Outdoor Automotive Other
If other, please explain
9. Do you have any material preferences?
Glass Acrylic Polycarbonate Other
If other, please explain
  Lamp Details:
 
10. Do you have a preference for the primary lamp to be used in this design and / or your product?
Yes No
11. If yes, please specify as much information about the lamp as possible:
Type: Metal Halide HPS Fluorescent Other
Wattage:
Envelope Style:
Style of Base:
Manufacturer Preference:
Catalog Number:
 
12. Do you have a preference for a secondary lamp to be used in this same design and / or your product?
Yes No
13. If yes, please specify as much information about the lamp as possible:
Type: Metal Halide HPS Fluorescent Other
Wattage:
Envelope Style:
Style of Base:
Manufacturer Preference:
Catalog Number:
14. If the lamp is not manufactured for the North American market, can you supply two samples?
Yes No Not Applicable
  Housing Details:
 
15. Have you selected a housing?
Yes No
16. If yes, can you provide drawings / sketches of the interior?
Yes No
17. Are there any obstructions that may affect reflector, lamp, or lamp socket placement?
Yes No
If yes, please explain
18. Is there any system components that may affect the light output or path?
Yes No
If yes, please explain
19. If necessary, can a sample housing be supplied?
Yes No
20. What are the dimensions of the luminous opening?
21. Have you selected a lens for the housing?
Yes No
22. If yes, what is the material of the lens?
Glass Acrylic Polycarbonate Other
If other, please explain
23. Can you provide drawings / sketches of the lens?
Yes No Not Applicable
  Performance Specifications:
 
24. Luminous Output
Desired Efficiency:
Beam Location:
Beam Dimensions:
What defines the edge of the beam: 50% of max 10% of max
25. Area Illuminance (What area will the luminaire illuminate)?
26. Location of area (relative to the luminaire)?
27. Area Dimensions?
28.
Illumination levels: Footcandles Lux Other
Average: Max / Min:
Maximum: Max / Min:
Minimum:
29. Any luminance requirements?
  Miscellaneous:
 
30. How are the final production pieces to be manufactured? What restrictions are to be placed on the design relative to tooling / manufacturing?
31. Are there any environmental restrictions?
32. Any other details you would like to include?
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