Contact Information (* indicates required information):


You will find it easier to complete this on-line form by first downloading the appropriate worksheet in pdf format, reviewing the information required and using it for reference when completing the information requested below. If needed, click here to download the necessary worksheet.
External Coil Worksheet
Inverted Coil Worksheet
Inverted Coil with Aluminum Holder Worksheet
Inverted Coil with Machined Retaining Ring Worksheet

For Inverted Coil with Aluminum Holder (additional information)
Note: See Brush Holder page for available holders)

For Inverted Coil with Machined Retaining Ring (additional information)

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