Gas Discharge Tube Order Form

Gas Discharge Tube Order Form
Submit your order for gas discharge tubes. Please provide all required details to ensure accurate processing and delivery.
Company Name
Contact Person's Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Shipping Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Billing Address (if different from Shipping Address)
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Select Gas Discharge Tube(s)
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Standard GDT (90V, 5kA)
Standard gas discharge tube, 90V breakdown, 5kA surge.
$2.50QuantityPackaging

High Voltage GDT (230V, 10kA)
High voltage gas discharge tube, 230V breakdown, 10kA surge.
$3.20QuantityPackaging

Custom GDT (Specify Below)
Custom voltage or size. Details must be specified in the comments.
$4.00QuantityPackaging

Total
$0.00
Preferred Shipping Method
Other (Specify in Comments)
Purchase Order Number or Reference
Requested Delivery Date
MonthDayYear
Date
Additional Comments or Special Instructions
Should be Empty: