Fields marked with an * are required.

Contact Information

Company Name *

Contact Name *

Phone Number *

Email Address *

RFQ Number

Part Information

Part Number

Glass Type *

Part Shape *
 Disc Rectangular Ellipse Prism Lens

Dia/Length and Tolerance

Width and Tolerance

Thickness and Tolerance

Other Notes

Material Quality

Index Tolerance

Dispersion Tolerance

Stress Birefringence

Bubble/Inclusion Spec

Striae Spec

Homogeneity Spec

Other Specs

Required Quantities *