Power Conversion Ultracapacitor Design Worksheet

The purpose of this form is to provide us with the key information that will allow us to help identify the best ultracapacitor alternatives for your application. Please complete as many items below as possible, so we can best address your requirements.


Customer information
*  Name: * E-mail Address
Company: * Phone Number:
Address: Fax Number:
* City/State: Customer Number:
* Zip/Postal Code: * Country

Project Information
* Application: Quantity Per System:
Sampling & Prototype Date: Estimated Annual Usage:
Estimated Production Date: Target Price:

Technical Requirements (Specifications)
*  Max. Working Voltage
*  Min. Working Voltage
*  Continuous Current (avg.)
----------> or * Avg. Power
*  Max. Peak Current
----------> or * Peak Power
*  Required Operating Life
* Run Time
(in seconds):
* Ambient Temperature
Duty Cycle
* Describe dimensions or Physical Size Requirements:
Desired Terminals:
Is this a new design? Yes
Is this a replacement part? Yes
Is a schematic available? Yes
If yes, we will arrange to receive it from you...
Type of Cooling Available?
Interest in Fabrication or Factory Assembly Services?
Special Hardware or Special Packaging?
* Required Fields