Customization Request Form

To better serve American Ultraviolet’s UV curing system customers, we have developed this specialized inquiry/order form. Using this form, our customers can specify their needs so we can propose the most appropriate UV system to meet those needs. Please complete the form, providing as much detail as possible and submit it. We will respond within a short time.

This is an request

First Name: *
Last Name: *
Email Address: *
	By entering your email address you are giving American Ultraviolet permission to send you e-mail.
Job Title:
Company Name: *
Type of Business: *
Address: *

City: *
State/Province *	(USA and Canada only)
ZIP/Postal Code *
Country: *
Daytime Phone: *
Fax: *

What will be cured?

Acrylic Adhesive Cyanoacrylate Adhesive

Epoxy Adhesive Silicone Adhesive

Conformal Coating Solder Mask

Ink Clear Coating

Laminating Adhesive Other

Who will supply the material? How thick is the material deposit?

If Web Application:

What substrate?

What is method of application?

What is web width?

If Individual Parts:

What are the parts made of?

Plastic Glass

Optical Fiber Other (fill in below)

Are any parts opaque?

Yes No

Will the assembly have shadowed areas?

Yes No

Specify the part's dimensions:

Length:

Width:

Height:

What type of curing system is needed?

Handheld Wand Handheld fiber optic light guide

Handheld liquid filled light guide Benchtop Chamber

Benchtop conveyorized system In-line conveyorized system

Retrofit System Large Conveyor

Shutter

What type of exposure is needed?

Flood Focus Beam

Spot

What wavelength is needed?

Ultraviolet C Ultraviolet B

Ultraviolet A Other:

What is the minimum energy required to cure the material?

Jcm²

Should the light intensity be adjustable?

Yes, from % to No

What is the exposure time?

Is heat on the web/part considered an issue?

Yes No

If a conveyorized system is needed, specify the following:

Belt Width:

Belt Length:

Belt Speed:

What auxillary equipment is needed?

Radiometer Cooling Fan

Air Knife Protective Eyewear

Stand and Shields Shutter

PLC Controls Additional light shielding

Mounting Brackets

Production Information:

Annual productions volume:

Production rate
(assemblies per minute):

Hours per shift:

Shifts per day:

Days per week:

Do you require installation assistance?

Yes No

Any additional comments:

Enter the code shown in the image: