JMS Southeast, Inc. - Engineering Request Form

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	Engineering Request Form
	Please take a moment to fill out our brief survey so we can better serve you,

General Information:

Company Name *

Customer Name *

Email

Phone

Fax

Sales Rep

Engineering Request Due Date

JMS Part #

Inquiry Classification (check all that apply):

General Technical Assistance

Drawing Assistance / Review

Material Specification

Bid Technical Review

Other (please expain)

Process Physical Characteristics:

Tnom (in Degrees Farenheit)

Tmax (in Degrees Farenheit)

Vibration (in g/Hz)

Pressure (in psi)

Vflow (in ft/sec)

Chemical Environment:

Oxidizing

Reducing

Inert

Vacuum

Process Chemistry (5-31, 33, 34)

Electrical Classification (NEMA/IP Ratings, Isolated Intrinsically Safe Temperature Measurement Circuits, & Hazardous Locations)

* Required field

Thermocouple, Thermowell and RTD products from JMS