BATTERY APPLICATION REQUEST FORM

Please use this form when requesting a quote or design assistance for a battery application or seeking assistance with the proper selection or design of a battery or battery pack for your project.

Company

First Name

Last Name

Address

Suite/Floor    

City         State

Phone   Fax

Application Profile

Immediate Needs: Sample Quote Design Concept

Application Requirements:
Battery Charger Other

Battery Chemistry/Type:
Primary Secondary Alkaline    
Nickel Cadmium
Carbon/Zinc   
Nickel Metal Hydride   
Lithium
Sealed Lead
Lithium Ion      
Other

Cell Data:
Cylindrical Prismatic

Volume/Delivery:

Annual Quantity   Samples needed

Target Price    Production Start

Electrical Requirements:

Voltage      Watt-Hours

AmpHrs

Runtime

Battery Electronics:    Fuel Gauge       SMBus

Gauge Accuracy            Other Communications

Gauge Display: LED/Switch          Communications

Safety Devices

Temperature Sense

Note: Pack Protection required for Li Ion Discharge Data:

Current: Max            Min

Watts: Max              Min

Duty Cycle: Peak     Duration

On Time

CHARGE DATA :

Charge Type:

Standard/Overnight
Quick, 4 to 8 hr
Fast, 1 hr   
Constant Current   
Constant Potential   
Both

Charge Rate:

Current      Time     Voltage

Charge Termination Type:

TCO
Timed
Cutoff V/cell
dT/dT
-dV
Other

Trickle Charge:

Rate     Time Rate

ENVIRONMENT:

Temperature:

Charge     Discharge

Storage     Humidity

Life Expectancy:

Cycles     Years

Special Requirements:

Vibration/Shock
Intrinsic Safety
Flammability
CSA/UL/FM approval
Other

BATTERY DETAILS:

Cell Configuration:

L x W x H

Dimensions:
L x W x H

Terminations:

Solder Tabs
Pressure
Connector
Wire Lead
Other

Construction:

Glue
Tape
Adhesive

Overall PVC   Plastic

Label:
Standard Special

Packaging

CHARGER REQUIREMENTS:

Type:
Desktop Gang In Device Other

Input voltage      Regulation

Status LED’s: Quantity Function

Notes: