Request a Lamp

To request a lamp, please fill in the following table with required fields and with as much of the lamp information as possible to help us design a lamp for you.

Name*
Company*
Street Address*
City*
State*
Postal Code*
Phone Number*
Email Address*
Country*
   
Lamp Part Number
Arc Length
Total Overall Length
Bulb Diameter
Single Ended or Double Ended?
Fitting
Other or Special Fitting Description

*denotes required Fields

Notes:

Note: A drawing of lamp may be required to ensure an exact match.