Testing Inquiry

If you wish to make an inquiry related to testing, please fill out the necessary information in the following form and send it to us. A representative will respond to your inquiry.

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 input the contents of your inquiry related to testing. A representative will contact you on a later date.*
Please select the tests you are considering to perform.*
(Please check all of the items that apply.)
Please provide us with information on your inspection object, puropose, and other required details.*
Attach Materials/Documents
If you have any supplementary materials or documents relevant to this request, please attach them.

If the reply address is different from the web member registrant, 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