Shielding Application Questionnaire. We Represent Manufacturers for your Custom Non-metallic Parts Requirements. cast urethane, die-cut parts and slit tape, dip-molding and coating plastic, extruded plastic, extruded rubber,plastic, molded composites, molded plastic, molded rubber

jobst incorporated

SHIELDING APPLICATION QUESTIONNAIRE

Fill out this form and fax it us: 952-447-3709.

We will promptly contact you with a solution so make sure and fill in your contact information at the bottom of the page.

EMI/RFI GASKETING ASSEMBLIES

Application:____________________________________________________________________

Gap Size:_______________________	tolerance:____________________
Environment: _____________________________________________________
Available Flange Width: ____________________________________________
Service Temperature: ______________________________________________
Groove Width: ____________________	tolerance: ____________________
Desired Closure Force: _____________	@ ______________			% _____
Groove Depth : ___________________	tolerance: ____________________
Can assembly Be Revised? _________________________________________
Mating Materials: _________________	Frequency Range: _____________
Coatings / Surface Treatments: _________________		Thickness: ________
Shielding Effectiveness Required (dB): _________________________________
Method of Attachment: _____________________________________________
Projected Start Date: ______________________________________________
Part Number and Name: ____________________________________________
Current Price: ____________________	@ _________________________
Target Price: _____________________	@ _________________________
Usage: _________________________	/year		Total ___
Other Solutions being considered: _____________________________________

Are Prints or Samples available for comparison and quoting purposes? ___________

How did you hear about us?____________________________________________

Your name: _______________________ Title: _____________________________ Company: _______________________ Dep't/Mailing Station: ________________ Address:__________________________________ Telephone: _______________ E-mail: ___________________________________ Fax: ____________________

jobst incorporated • po box 8 • prior lake • mn • 55438 • 952-447-3904 • 952-447-3709 sales@jobstinc.com • www.jobstinc.com

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