Request Free Product Trial

If you wish to test units (free of charge), then CCS offers no cost, no obligation trial units available for a 30 day evaluation period. Please fill out the necessary information in the following form and send it to us. A representative will respond to your request.

We require that you fill in items marked with an asterisk (*).

Please rest assured that in no case will we ever individually disclose any private information that we receive to external parties. For more details, please refer to our company's "Privacy Policy."

Intended use for Light Units, UV irradiators, or Light Sources*
Please provide us with a description of what you will test when using the testing units, as well as any additional requests that you may have.*

Input example: LNSP-100SW-FN×1

Desired duration of Free Product Trial* Date of arrival:
Date to be returned:
* We will contact you in the event that we are unable to comply with your request.
[Control Unit]
[Cable]
Please provide us with a description of what you will test when using the testing units, as well as any additional requests that you may have.

If you wish to specify a delivery address that is different from the address you provided during membership registration, please provide it below.

We require that you fill in items marked with an asterisk (*).

Company / Organization*

Please enter your official company name and office name.

Name of Sales Office/Branch/Business Location
Section / Department*

Please enter your official department name.

Title
Name*
Address Zip / Postal Code*
Country*
Address*
City*
State
Phone*
Fax
E-mail*

Please provide us with your company's current status in relation to the purchase and implementation of lighting/light irradiation fixtures/light sources.

Q1. When do you plan on purchasing/implementing new Light Units, UV irradiators, or Light Sources?*
Q2. What is your purpose for purchasing/implementing Light Units, UV irradiators, or Light Sources?*
Q3. If there are existing products that you are currently making use of, please let us know what they are.

Manufacturer Name

Model Name

Number of Units Installed