Micro Dispensing Quotation Request Form

The following information is required to assist our personnel in the selection of the best micro dispensing system for your specific application.  Fields marked with ( ) are required. Please call us if you have any questions on +44 (0)1295 277731

YOUR CONTACT INFORMATION

Title    Contact name     Company  Address      City  County / State  Postal code  Country  Phone  Fax    Email  Website address          Target location for equipment   Select where the equipment is being used Specialist Machine or Line Builder End User

BRIEF DESCRIPTION OF YOUR APPLICATION

SECTION 1 - MATERIAL SPECIFICATIONS

Material manufacturers name  Manufacturer contact name  Contact telephone  Contact email address  Product name  Product code  Type of product Please Select Product Type UV Cure Adhesive Anaerobic Adhesive Epoxy (Single Part) Silicone Grease Oil Flux Other - Please Specify If other, please specify  Viscosity @ 25°C (77°F)   Select Units cps Poise mPas Other If other, please specify units  Physical description of the material   Please describe - i.e. like maple syrup, toothpaste etc...  Processing temperature  °C  Viscosity @ process temperature   Select Units cps Poise mPas Other If other, please specify units  Specific gravity of the material g/cm³  What filler type is in the material  What is the filler content  % by weight  Is there any filler settlement Select Yes / No  Yes  No   Supply container size Select One 10cc Cartridge 30cc Cartridge 1 Litre Can 5 Litre Can 25 Litre Drum Other Volume If other, please specify    Heating required?  If YES, enter Temp  °C   Any special heating requirements ?  Level seeking material ? Select Yes / No  Yes  No   Is the material thixotropic Select Yes / No  Yes  No  If YES, by how much ? Select One Slightly Thixotropic Moderately Thixotropic Highly Thixotropic  Is the material abrasive Select Yes / No  Yes  No  If YES, how abrasive ? Select One Slightly Moderately Very Abrasive  Moisture Sensitive Select Yes / No  Yes  No  If YES, how sensitive ? Select One Slightly Moderately Very Sensitive  Any reactivity with other materials Select Yes / No Yes No  If YES, please explain  Clean-up solvent needed  Dispense valve mounting Select One Mounted on Machine Mounted on Fixture Mounted on Robot  Dispense application type Select Application  Adhesive Bonding Dot Dispensing for SMT Lacquer Coating Doming & Globbing Encapsulating Beading Lubricating If other, please specify  Dispense control method Select Dispense Method   Operator Controlled Machine Controlled Robot Controlled If other, please specify

SECTION 2 - SHOT APPLICATION SPECIFICATIONS

Do you have a SHOT or FILL application - if you do, please complete this section, otherwise go to Section 3  Please describe the part  Type of Shot Select Shot Type Metered Single Shot Multiple Shot Visual Operator Controlled Both by what method Select One Manually Positioned Articulated Robot Cartesian Robot  Time allowed for dispensing   Select One millisecond second minute  Time between each dispense   Select One millisecond second minute  Time to index to next dispense point   Select One millisecond second minute  Shot volume per dispense   Select One nano litre micro litre milli litre with Tolerance +   %  Do you have more than 1 shot volume Select Yes / No Yes No If Yes, what is the range ?  How often do you switch shot volumes Select One Frequently Once a day Once a week Occassionally  Please provide more information  How many dispense points per part  Are you dispensing under vacuum Select Yes / No Yes No If Yes, what vacuum depth          mmHg  Now proceed to Section 4

SECTION 3 - BEADING APPLICATION SPECIFICATIONS     Please complete this section for your BEADING application and then proceed to Section 4  Please describe the part  Method of applying the bead Select One Manually Applied Bead Fixture Mounted Applied Bead Beading by Articulated Robot Beading by Cartesian Robot  If Robotic, what level of supply Select One Already own robot system Need Robot System Supplied  Bead Dimensions Length   mm    Diameter   mm    Tolerance +   %  Is Knit-Line precision important Select Yes / No Yes No If Yes, to what level ?  Bead dispensing speed required  mm/second    Number of dimensions Select One XY XYZ  Time between each bead  per  Select One millisecond second minute  Time to index to next dispense point  per  Select One millisecond second minute

SECTION 4 - POWER & PNEUMATIC REQUIREMENTS

Electrical Supply  Volts              Phase              Amps   Pneumatic Supply  PSI or   Bar     CFM    Treatment Select One Filtered Lubricated Filtered & Lubricated

OTHER USEFUL INFORMATION

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