NEBS™ Technical Analysis/Testing Questionnaire -
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Please fill out this questionnaire, and we will contact you shortly.

(* = Required fields.)

First Name^*
Last Name^*
Company Name^*
Street Address1^*
Street Address2
City^*
State^*
Zip^*
Country^*
Phone No.^* (i.e. xxx-xxx-xxxx)
Fax No.^* (i.e. xxx-xxx-xxxx)
Email Address^*
Product Information
What is the product called?^*
What does the product do?^*
What stage is the product in?
Where is product going to be used?
How is it powered (check all that apply)? AC DC - 48V Other - If so, please specify
Does it rack mount or is it free standing?
What are the dimensions?
What areas of NEBS are you interested in?
Why are you interested in areas of NEBS you provided in previous question?
What are the cable connections to the product?
Do any metallic cable connections to your equipment leave the building or go directly to the outside plant prior to terminating at other equipment?
Are any of the cables unshielded?
Are particular Bell Operating Companies or other service providers interested in your product and/or interested in participating in the qualification?
What is you testing timeframe?
Can you send some product literature describing the product?
How did you learn about our NEBS testing services?

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