EMC Application Form

SECTION 1 - YOUR COMPANY
Company Name
Contact Name
Address
Postcode
Telephone number
Mobile No:
Fax number
Email
Web site
SECTION 2 - THE EQUIPMENT TO BE TESTED
Model name/Number
Description of use
Hardware version
Software version
Type of testing required
SECTION 3 - ABOUT THE TESTING REQUIRED
Do you want to attend the testing?
Is the test part of a development programme
Environment product is to be used in
Which countries / territories is the product to be sold into
Territory 1
Territory 2
Territory 4
Territory 3
Standards required
Commercial Emissions Standard 1
Commercial Emissions Standard 2
Commercial Immunity Standard 1
Commercial Immunity Standard 2
Other EMC Standard
Other EMC Standard
Other
Notes
SECTION 4 - TECHNICAL INFORMATION REGARDING THE EQUIPMENT TO BE TESTED
Power supply
Is the equipment attended whilst in use?
Is equipment switched on manually/automatically?
What is the products primary power
Current requirement
Frequency of supply
Single phase/3 phase
If DC supply, is it supplied with a plug top AC adapter
How long is the DC cable
Input output cables
Does unit have any external cables (other than power)
How many are over 3m in length?
Number of screened cables
How many cables connect directly to outside cables?
Does the product have any external antenna connections
Physical properties of equipment
How long will it take to setup
Product handling requirements
Size of the product
Does the product require any special support (Water/Air)
Electrical properties of the product
Does it have clock oscillators above 9KHz
If yes, please give frequency
Does the product contain magnetically sensitive components?
Does the unit contain a radio tx/rx device?
If Yes, please give frequency
Does the radio carry its own approval
Modes of operation
How many modes of operation will require testing
Failure Criteria
Describe how we can monitor the equipment
SECTION 5 - PROVISIONS OF REPORTS
Report required
Summary test report (175.00)
Full test report (350.00)
Test Certificate (75.00 only with above report)
Paper copies of graphs on the day (FOC)
Electronic copies of graphs on the day (75.00)
Letters or email summary with graphs (75.00)
Please note that other than by appointment, reports are only released on payment of all invoices relating to that task
SECTION 6 - Additional Services
Do you require rectification/suppression consultancy
Do you require low voltage directive approval testing
Do you require competent body services
YOUR DETAILS
Your name
Your position
Date