AUTOPILOT INFO REQUEST FORM

1)  Customer Name: 
 Address:  Street: 
             City:      State: 
	  Country:   Zip Code: 
           e-mail: 
            Phone: 
              Fax: 

2)  Geographic area of vessel usage:
                   


3) Type of Vessel:  Power
                    Sail
                    Pleasure
                    Commercial

                   If commercial, what type of usage:
                   

    Vessel length: 
                    Feet,  Metres


4)  Type of drive:  Inboard
                    Outboard
                    Inboard/Outboard

     Boat Voltage:  12 VDC,  24 VDC,  32 VDC,  110 VAC


5) Cruising Speed: 
        Top speed: 
      Speed Scale:  KNS,  MPH,  KPH


6)  Hull material:  Fiberglass
                    Wood
                    Steel
                    Aluminum
                   Other: 


7)  Steering Type:  Hydraulic
                    Mechanical
                   Other: 

    If mechanical, specify type:
                    Cable
                    Worm Gear
                    Rack & Pinion


8)  If hydraulic, please specify ram size (displacement)
    in cubic inches or cubic centimeters:
                     Inches,  Centimetres 

    Alternately, specify the make and model of your system: 
                   

    If ram size or make and model are not available,
    please refer to the drawing below and make the 
    measurements as indicated:

                   

           Stroke:   Inches,  Centimetres 
      Barrel dia.:   Inches,  Centimetres 
         Material: 


 9) Please specify the type and number of
    Autopilot Stations you require:

    Fixed Stations:     
    Portable Stations:  

10)  Brochures and Information Request:
                    Autopilots
                    Instruments
                    Compasses
                    Marine PC / Sunlight LCDs

11) Please specify where you heard about ComNav Autopilots:
	

12) Comments
	

Submit request...  

ComNav Marine Ltd.
#15 - 13511 Crestwood Place
Richmond, BC Canada V6V 2G1

E-mail: sales@comnav.com
Phone:	604-207-1600
Fax:	604-207-8008