Schmitz Engineering Liaison Order Page

SEL Order Form

The detailed encoder specifications in PDF format include instructions for constructing the appropriate encoder model number. Please give us a call if there is any difficulty in arriving at your model number.

In any event we will telephone you upon receiving your E-mail or FAX of this form for a technical discussion to be sure that the encoder is correct for your application and to quote price and delivery.

THANK YOU for considering us as your encoder source!!!

Item #1: Qty:
Notes:  

Item #2: Qty:
Notes:  

Item #3: Qty:
Notes:

Purchase Order #: (following phone discussion)


** We must have a name and a telephone number of a person at the shipping address **

Ship To: 
Address: 
   City:  State: Zip:
 Hm Tel:  Wk Tel:
 E-mail: 

Bill To: 
Address: 
   City:  State: Zip:
 Hm Tel:  Wk Tel:
 E-mail: 

Credit References: one bank & three suppliers (not needed if
                                       you have an account with us)

      Bank: 
   Address: 
      City:  State: Zip:
       Tel: 

Supplier 1: 
   Address: 
      City:  State: Zip:
       Tel: 

Supplier 2: 
   Address: 
      City:  State: Zip:
       Tel: 

Supplier 3: 
   Address: 
      City:  State: Zip:
       Tel:

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Schmitz Engineering Liaison
124 S. Dodge Street
P.O. Box 542
Burlington, WI 53105
Tel: (262) 763-3036
Fax: (262) 763-3015
©1997