New Battery Worksheet

Customer Profile:

Company:		Contact Name:
Title:		Email:
Address:		City:
State:		Zip Code:
Phone:		Fax:

General Description of Portable Power Source Application:

Application Information:
Existing Product?:	Yes No
If yes, Manufacturer and Part#:
Target Price (USD):
First Delivery:		Quantity/Month:
K pcs/year:		How many years?:
Chemistry/Rechargeable:		Chemistry/Primary Battery:
Fuel Gauge:	Yes No	SMBUS:	Yes No
Safety Standards:
Special Requirements:

Battery Mechanical and Electric Requirements:

Battery Pack form:		Dimensions (L x W x H):
Battery Configuration:	(P) x (S) x
Nominal Voltage (V):		Rated Capacity (A/h):
Typical Discharge (mA):		Max discharge (mA/sec):
Charger Required?:	Yes No

Copyright 2007 Bren-Tronics, Inc.