ACTION FAX: Toll Free FAX Number: 1-800-345-2831
(Print form out, fill in, and fax back to Regal)
To help us provide you with the speaker or speaker assembly you require,
please assist us by providing the following information:
 
Company name:_______________________________________ Contact:________________________
 
Address: ____________________________________________________________________________
 
City:____________________________________________State:____________Zip:__________________
 
Phone:__________________________________Fax:_______________________________________
 
E-mail: ___________________________________________________________
 
Rep firm: _______________________________________________________
 
Salesperson: ____________________________________________________
 
Specifications

Speaker size:  Outer diameter: _________ inches (or mm);  Height: _________ inches (or mm)
 
Speaker configuration:       ___ Round        ___ Square        ___ Oval
 
Magnet type:   ___ Alnico       ___ Ferrite          ___ Other:_______________
 
Voice coil impedance:  _______Ohms               Power input:  _______watts nominal, _____ watts max
 
Required frequency range: ________ Hz to ______________ Hz;  SPL: ________dB
 
Application (voice, music, alarm, etc.): _________________________________________
 
Quantity to quote:_________________________________________________
 
Design Sketch:
  
Special Requirements (wiring harness, connector, environmental requirements, etc):
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________