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Application Evaluation Request Form

Having trouble capturing the crisp, clear images your machine vision system needs? Let us help. Just complete this evaluation request and our Application Engineers will recommend the right light for your application.

First name
Last name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail

Please describe the application and what is being imaged
What are the dimensions of your Field of View (X and Y axis)?
What is the Background?
Can the part be backlit?
Yes  No

How close can the light be mounted to the part?

Lens type used?
What is the lens to part distance?
Continuous or strobed application?

Color or B&W Camera?
Vision System Provider:
Any environmental factors (oil, heat, moisture, etc)
Yes No
If yes - briefly describe
Can you provide samples for us to image?
Yes No
Do you need them returned?
Yes No
May we use images of your part for training purposes?
Yes No
How many systems require lighting?
What is your install date?
Additional application comments:
How did you hear of NERLITE?
  
Who will you buy your NERLITE products from?
What is the supplier's name or Siemens office location (e.g. Acme Distribution; Siemens-Spain)
Note: After you click the 'Submit Form' button, a confirmation page with directions on what to do next should appear.  Shortly thereafter, members of NERLITE's Evaluation Team receive a copy of your submission in their e'mail inbox.  If the above process does not appear to be working, or if you have any questions about the evaluation process, please let us know!
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