* Indicates required field

*Company Name:

*Name:

*Title:

*Address Line 1:

Address Line 2:

*City:

*State / Province:

*Zip / Postal Code

*Country:

*E-mail Address:

*Phone:

Fax:

URL:

Material being advanced:
(Paper, Mylar, Steel etc.)

How thick is the material:

Perforation Type:

Round
Square
Rectangular

Perforation Size:

+/-

Pitch (Spacing):

+/-

Is material to run tangent to sprocket?:

Yes
No

If no, what is the engagement
or wrap with the sprocket?:

degrees

Will the material be edge guided?:

Yes
No

Number of sprocket teeth
(or sprocket diameter):

Sprocket material:

Is weight of sprocket (inertia) a consideration?:

Yes
No

Is corrosion (environment) a consideration?:

Yes
No

Sprocket speed:

RPM
FPM

Film suport method:

Bore size required:

+/-

or Shaft size:

+/-

Fastening method:

Is keyway required?:

Yes
No

(if yes, answer below)

Size of keyway:

Is keyway related to teeth?:

Yes
No

Overall length of sprocket:

+/-

Quantity requirements:
(Specify multiple quantities if required)

Delivery requirements:

weeks

Please provide additional information below if helpful.

Design Assistance Information