Request a Lamp

To request a lamp, please fill in the following table with required fields and with as much of the lamp information as possible to help us design a lamp for you.

Name*
Company*
Street Address*
City*
State*
Postal Code*
Phone Number*
Fax Number*
Email Address*
Country*
   
Lamp Part Number
Arc Length
Total Overall Length
Bulb Diameter
Lead Wire Length
End Terminal Type
Wattage
Volts
Amps

*denotes required Fields

Notes:

Note: A drawing of lamp may be required to ensure an exact match.