G703 Amplifier Enquiry Form
Please select the options required and then submit this form for immediate attention. We will then confirm your enquiry with the appropriate type number and price, or reply to your custom requirements. Please note that items marked "Standard" are the quickest to obtain, but even other units only take around another 2 weeks, usually.
Enquiry Form:
Name :
Company :
Position :
Address :
Country:
Post / ZIP Code:
E-mail address:
Telephone Number:
Fax Number:


Please specify your Amplifier Requirements (Check "OTHER" if it does not appear)


First pick your Amplifier configuration

2 inputs and 2 outputs (Standard Box)
2 inputs and 4 outputs (Standard Box)
1 input and 2 outputs (Standard Box)
1 input and 3 outputs (Standard Box)
1 input and 4 outputs (Standard Box)
Boxed Other Variation
19" Rack 3U 48 inputs 48 outputs (24 x PCM)
19" Rack 2U 32 inputs 32 outputs (16 x PCM)
19" Rack 1U 16 inputs 16 outputs (8 x PCM)
19" Rack Other Variation
Other

Now, what type of Input Connectors ?

BNC (Standard)
BT43 (Standard)
Bantam
RJ45
1.6/5.6
Screw Terminal
Other

And now, what type of Output Connectors ( if you have TWO outputs, this is for the FIRST output)?

BNC (Standard)
BT43 (Standard)
Bantam
RJ45
1.6/5.6
Screw Terminal
Other

If you have TWO outputs, what type of Output Connectors for the SECOND outputs ? (Ignore if only ONE output)

BNC (Standard)
BT43 (Standard)
Bantam
RJ45
1.6/5.6
Screw Terminal
Other

What Power Supply would you like to use?

9v-12v DC External (Standard)
5v DC Local Supply (Must be "clean") (Standard)
Local DC Supply between 12v and 55v
230v Mains
115v Mains
Other

What Bitrate do you require?

64K
2048K (Standard)
1544K (Standard)
Other

What Output Impedance would you like?

75 Ohm (Standard)
100 Ohm
120 Ohm (Standard)


If you have checked any "Other" boxes above, please specify the details of your other requirements



How many Amplifiers (Or Amplifier Rack Units) do you require?



How many Power Supplies do you require?



Please check all of the form, to make sure you have given us enough information to be able to reply to you, then click on the SUBMIT button
If you wish, you may print your enquiry from the next page, for reference


However, if you want to clear ALL of the above information and start again, click below:
Our Contact Details are:

Pervisell Ltd
8 Temple End
High Wycombe
Bucks
United Kingdom
HP13 5DR

Telephone (from UK) 01494 443 033
Fax (from UK) 01494 448 236

Telephone (International) +44 1494 443 033
Fax (International) +44 1494 448 236