INFORMATION REQUEST

Information Request Form

* = Required Field

Contact Info

* Name:

* Email:

* Company:

* Company Type:

(Architect, Engineer, LA, City, School, etc.)

* Address:

* City:

* State:

* Zip:

* Phone Number:

Fax Number:

Project Details

Date:

Project Name:

Location:

Fixture Info

Fixture Style:

Catalog Page:

Finish:

Lens (If Applicable):

Number of Fixtures Required:

(If multiple, specify arms and configuration)

Lighting Info

Light Source:

MV MH HPS QL PLT INC
Voltage
As a general rule, 175w and under HID lamping will use a medium base socket, 250w and over will use a mogul base. Consult factory if a different socket is required.

Wattage:

(See catalog for maximum wattage available for future size/style)

Optical Info

Optics:

Refractor Reflector Roof Optics
Specify:

Pole Info

Pole Style:

Page:

Finish:

Number of Poles Required:

Height:

Accessories

Banner arms:

Single Double
Convenience Outlet	Flag Pole Holder	Planter Arms
GFI	Photocells - PEC	Sign Arms
Other Accessories (Specify):

Streetscape Imaging

I would like to order a Streetscape Imaging II CD.

Please Send Me:

Catalog

Drawing

Quote