Membrane Switch Quote * Required Field Contact Information Company Name:  * Contact Name:  * Phone Number:  * Fax Number:  Email Address:  * How did you hear about GVP Inc.?:  -- Please select one --ReferralTrade MagazineInternet Search EngineTelephone or Other DirectoryOther If Other, list here:  Part Information Part Number:  * Expected Annual Usage:  * Requested Tolerance +/-:  * Material Required:  * Required Overall Thickness:  Is this switch in the prototype stage?:  Yes   No Do you have a print?:  Yes   No Do you have an established pin-out?:  Yes   No Do you have an existing digital file?:  Yes   No Do you have existing tooling?:  Yes   No Overall Switch Dimensions:  (including the tail)    * Tail Length:  Location of the Tail:  Internal   External Number of Switch Layers:  Does this switch need to be shielded or grounded?:  Yes   No If yes, does it require its own tail?:  Yes   No Does not apply Internal or external venting?:  Internal   External Actuation Type:  -- Select One --Metal DomesPolydomesDielectric Bridge - Flat Switch* Number of Buttons:  * Embedded LEDs:  Yes   No Number of Embedded LEDs:  Number of Pins:  * Dimension on-center for the Pins:  Termination Type:  -- Select One --AmpBergZIFSolder TabsOther* If Other, list here:  Does this switch require carbon on the tail?:  Yes   No Does not apply Is the housing latched or unlatched?:  Latched   Unlatched Does not apply Environmental Information Operating Environment:  -- Select One --IndoorOutdoorHigh Altitude* Specific Operating Conditions:  (Extreme Heat or Cold, High Humidity...etc.)    What chemicals will this be exposed to?:  Type of Application:  What type of material will this switch be applied to?:  HSE   LSE Metal   Other* If other, please list type:  Is this a disposable, one time use, switch?:  Yes   No Required Actuation Life:  Does the switch require Medical Grade Components?:  Yes   No Does this membrane switch require a graphic overlay?:  Yes   No* *If this part requires an overlay, please fill out a separate Graphic Overlay Quote Form. Other Details / Instructions   Membrane Switches   Sensors   Graphic Overlays   Custom Labels   Pad Printing   Custom Design

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