Cable Assembly and/or Cordset Design
(Basic Form)

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Please describe the cable assembly or cordset you need including all known specifications:

End application type:
Medical Military/Defense Naval/marine/shipboard/undersea Aeronautical/Avionics Hybrid
Instrumentation Industrial Other
What would you like us to do with this information?
Design Validation Budgetary Estimate Quotation
Would you like a protype? yes no     Prototype Qty: (ft)
Min Production Qty desired: (ft) Max Production Qty desired: (ft)

Contact Information
Company Name:

Contact Person:



Email Address:
Street/PO Box:




Preferred Conact Method:
Phone Fax Email
last update: 12/12/05

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