Quotation and Information Request Form

Quotation and Information Request Form

To receive the fastest response, please call Lasermate Group, Inc. at (909)718-0999 or (909) 623-4995.

If you have any comments or requests for product information, please fill in the following form:

Name:
Company:
Mailing Address:

Tel: Fax:

e-mail:

Note: If your browser does not support forms, e-mail your request to:info@lasermate.com

To receive more efficient response, please check one or more of the following products of interest.
Red & Infrared Laser Diode Modules (635nm -980nm)
Please Indicate:
Wavelength: Optical output power:

Operating voltage: Operating temperature:

Beam Shape: Focus:

Dimensions: Applications:

Model No.:

Quantity: Delivery time required:

Communication Laser Diode (850nm, 1270nm -1610nm)
Connectorized Laser Diode
Fiber Optical Transceiver

Please Indicate:
Transmitter Wavelength:

Output power: Package:
Model No.:
Quantity: Delivery time required:

PIN Photo Diode
Connectorized PIN Photo Diode

Please Indicate:
Detecting Wavelength: Package:
Model No.:
Quantity: Delivery time required:

Laser Diodes (635nm -1550nm)
Please Indicate:
Wavelength: Maximum Output power:

Model No.:
Quantity: Delivery time required:

Laser Pointers

Please Indicate:
Wavelength: Output power:

Model No.:
Quantity: Delivery time required:

Laser Aimers

Please Indicate:
Wavelength: Output power:

Applications:
Quantity: Delivery time required:

Green Laser Module

Please Indicate:
Output power: Operating voltage:

Applications:

Model No.:
Quantity: Delivery time required:

Accessories (Circuit board, Optics, etc..)

Please Indicate:
Item:

Model No.:
Quantity: Delivery time required:

Comments:

If you have any comments or request for detail product information, please fill the
Quotation & Information Request Form or mail to: info@lasermate.com.

Lasermate Group, Inc.
1987 W. Holt, Ave., Pomona, CA 91768, USA Tel: (909) 623-4995 Fax: (909)623-4915

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