Note: * Required Fields
Customer Information
* Contact Name :
* Phone (10 digit min.) :
* Email Address :
Address :
State :
 
Job Title(s) :
Fax :
Company Name :
City :
Zip :
Current Motor
* Motor Manufacturer
* Motor Part Number
* Motor Label Photo ( .jpg, .gif, .tif, .png) :
* Overall Motor Photo ( .jpg, .gif, .tif, .png) :
Motor Type (AC, DC brush, DC perm magnet, etc.)
Voltage
Duty Cycle Requirements : (Ex. 10% ON, 50% ON, Continuous)
* Motor Shaft Type Needed (choose option below for examples):
Straight Output Shaft
Splined Output Shaft
Other
* Differential/Transmission or Belt/Chain Gear Ratio: (Ex. 12:1)
Comments :
Project Information
Project Vehicle (Make, Model, Year): (Ex. Kawasaki, Ninja 650, 2012)
No Load Weight:
Full Load Weight:
Drive Tire Diameter:
Quantity of Motors Per Year :
Comments :
Performance Requirements
H.P. :
RPM :
Max. Vehicle No Load Speed (on level ground):
Max. Vehicle Full Load Speed (on level ground):
Max Vehicle Incline: % Grade
What vehicle range or application duration are you hoping to achieve?
(Ex. Miles, Mins., Hours?)
Comments :