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Rudower Chaussee 29-31 (OWZ), D-12489 Berlin, Germany
Tel: +4930 / 6392-6620; Fax: +4930 / 6392-6622

INQUIRY #
to MolTech GmbH, Berlin, Germany
We are interested in optical elements/substrates made from
for the following purposes:
Please give possibly detailed description of the elements.
Dimensions and tolerances:
the drawings will be forwarded by FAX / E-Mail attached file or
a = mm; b = mm
c = mm; dia. = mm
form and dimensions:

BLOCK or BLOCK

Dopant concentration:
Please specify the dopant concentration, if necessary.
Treatment of the working surfaces:
as-cut / inspection / optical / laser
Please select button
Coating: Please describe the type of coating (AR-, protective, reflection etc.) and the wavelengths, if necessary.
Comments: This field is for an additional information such as orientation, other form of elements, etc.
Company:
Address:
Please type your company's name and mail address
Your Tel-No.: Fax: E-Mail:
Name:  Date:

INQUIRY #
to MolTech GmbH, Berlin, Germany
We are also interested in the elements made from the same material with the following distinctions:
Please describe the difference between the previous elements and this one.

Don't forget to send the completed form to the PRINTER before pushing the button SEND !

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