After selecting one of the above, please complete the following form or click the link below. Note, the more information you provide, the faster we can provide you with the needed service.

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WHAT TYPE OF PRODUCT?
(Select all that apply, using the check box in gray area, please be as specific as possible for each category selected by filling in the questions of that section)

Radio Equipment:
Frequency Range (in MHz)
Number of Channels
FCC Rule Part or CE Standard (If Known)
If the device is a spread spectrum or UNII device, please complete the following:
RF Power Output (in dBm or watts)
Frequency Hopping Spread Spectrum Other
Number of Antenna Types
Highest Gain (in dB)
Is the Device Portable? <20cm from user with respect to antenna distance (please select distance/range)	<2.5cm >2.5cm & <5cm >5cm
Is the Device Mobile? >20cm & <2m from any person with respect to antenna distance	Yes
If Mobile, how close would any person come to the antenna or radiating elements of this device?
Information Technology Equipment:
Type
Description
Other:
Please describe the product in detail:

PRODUCT DESCRIPTION/INFORMATION

WHAT TYPE OF TESTING DO YOU REQUIRE?
(check all that apply)

CONTACT INFORMATION
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Company Name:*
Your Name:*
Email Address:*
Phone:*
Fax:
US Address:
Street Address:
City:
	State: Zip :
Other than US:
Country:
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