For the fastest possible service please be sure to include your contact information as well as your fax number. Please fill out the form below, skipping any questions that do not apply. Then click the send button at the end of the page to send the information to us. Your Name Company Project E-Mail: Phone: Fax 1. Maximum allowable size of fixture (including lamp) Length  Width Height # of Lamps 2. General type of fixture (select the one that applies) Light Strip Light Pan Wraparound Circline Flat Plate Side Socket Strip Undercabinet 3. Do you have a particular lamp type requirement? (If not, skip this section) If Yes indicate type Is Color Rendering important ?   Yes  No   Color  Cool White  Warm White  Daylight  Other   (specify color) 4. Do you need a cord and plug? (If not, skip this section) If so, please enter Cord Length   Color   (Black is Standard) Straight Plug Right Angle Plug 5. Do you need a convenience outlet? (If not, skip this section) Convenience Outlets Will units be interconnected Yes No If so, how many 6. Is Underwriters Laboratories approval required? Yes   No 7. Are there any particular light output requirements? If so, please describe your requirements 8. Do you need a switch? (If not, skip this section) Rotary Switch Pull Chain Toggle Switch Rocker Switch 9. Are special mounting holes required? (If not, skip this section) If Yes, please fax us a sketch or drawing to (631)-777-7705 Slot  Keyhole 10. Material requirements White Steel (std.)  Aluminum  Galvanized Other (please specify) 11. Special paint color Please indicate paint numbers 12. Is overcurrent protection desired?  (Fuse and fuse holder, cord-mounted curcuit breaker, etc) If so, please indicate which type 13. Packaging requirements Individually boxed Bulk   Other (please describe below) Other (please describe your packaging requirements) Special labeling requirements 14. Do you need protective tube guards (If not, skip this section) Protective Tube Guards 15. Ballast type, select all that apply (Selection may be dependent upon lamp type) Pre-Heat   Rapid Start  Electronic  T-8  T-12 Lowest cost option  Smallest Available Option 16. Is a diffuser and/or a specular reflector required? If so, please describe 17. Is this a one time project or ongoing? One-time project  Ongoing project Please describe your project 18. Quantities desired for quotation: Please enter the quantities you would like us to quote 19. Approximate date required:  20. Additional notes, comments or special requirements To continue, please type the characters as you see them in the image above