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Multi-Mix® Qualification Form

Please fill out all of the following information so we can process your request as quickly as possible. Or e-mail: crm@merrimacind.com.

Name
Title
E-Mail Address
Phone Number
Fax
Company Name
Mailing Address
 
Shipping Address
 
What application do you plan to use these products for?
Commercial SATCOM Military
Please provide an application description and any screening requirements:
What is your potential volume or usage?
When will production begin?
Specify the model number(s) and frequency(s):
What power level(s) are you operating at?
What is your target pricing for these products?
Are there any size requirements that need to be met?
Are there any special requirements?

 
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