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
 
Environmental considerations:
   Production environment: Will the speaker be subjected to high temperatures as part of the production process (e.g. wave soldering)?

   Operating environment: Will the speaker be operating in high temperature and/or high humidity environments, or be subject to high stress mechanical environment?

Application (voice, music, alarm, etc.): _________________________________________
 
Quantity to quote:_________________________________________________
 
Design Sketch:
 
Other Special Requirements (wiring harness, connector, environmental requirements, etc):
__________________________________________________________________________________
__________________________________________________________________________________
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