Switch Sample Request Form

Please take a moment to complete the following questionnaire.   These questions are all necessary to provide the best switch for your requirement.

Your Name:

Your Title:

Company Name:

What does your company make:

Years in Business: yrs.

Phone (w/extension):      Fax: 

Street  Address (with State and Zip Code):

  

E-Mail Address: 

How did you hear about us?:

Type of Switch:

Switch Function:

What is your anticipated annual quantity:    

What is your anticipated release quantities:    

(Judco's pricing is based on shipped quantity.  Minimum order is $250.00 per part number.

What is your application (This information is critical, please be specific):

Is this an OEM Automotive application?: 

What are the Volt  Requirements?

What are the Amp Requirements?

Please choose your wire terminal configuration below:: 

 

 

bulletIf Wires

                    Wire Gauge (UL requires 18g):     

Wire Length (Standard is 4.5"):    Strip Length: 

Do you require a quick connect terminal on the end of the wire: 

bulletIf Terminals

                    Style of Terminal:     

Will Terminals be soldered:   

Do you require UL approval?: 

Do you have space limitations?: 

What is the cycle life requirement?: 

Will the switch be exposed to the outside elements (i.e., water, dust, sun, etc.)?: 

Do you require a protective boot?: 

Spike Concern?:      Millivolt concern?: 

Do you use heat shrink tubing?:   

If yes, would you like to save 80% on your labor cost and reduce your shrink time to just 2.2 seconds?  Please click here to view our newest product, the Focus-Lite Heat Shrink Processing Machine.

How would you like to be contacted: 

Additional Comments?

Thank you for taking the time to complete this request form.  Please print this form for reference, then hit the submit button to send your request.  We will contact you with the switch or component that best fits your requirements.  If you have any questions, please contact our friendly sales staff at (310) 534-0959.