Request Form:
Company Information:

Company Name: Address:
Contact Name: City:
Phone: State:
Email: Zip:
Fax: Country:

Model Specific Questions:

Outside Radius
Inside Radius
Belt Centerline Radius
Frame Height
Bed Width
Outside Trim Width
Roller Diameter
Quantity required
Product to be conveyed
Size of product (LxWxH)
Total weight of product
Degrees of turn
Directions of flow (CW CCW or Both)
Drive location (lx, ly, rx, ry, other)
Required speed at center line
Top of bed height
Support (floor/ceiling)
Drive furnished by (Jantec/other)
Comments