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value='Singapore' >Singapore</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Sudan, South' >Sudan, South</option><option value='Suriname' >Suriname</option><option value='Swaziland' >Swaziland</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria' >Syria</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania' >Tanzania</option><option value='Thailand' >Thailand</option><option value='Togo' >Togo</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkey' >Turkey</option><option value='Turkmenistan' >Turkmenistan</option><option value='Tuvalu' >Tuvalu</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' >United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Vatican City' >Vatican City</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option></select></div></li><li id="field_1_41" class="gfield gplaceholder half first gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_41' >Postal Code<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_1_41' type='text' value='' class='large' tabindex='110' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_55" class="gfield gplaceholder half dropdown last gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_55' >Product Group<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_1_55' class='medium gfield_select' tabindex='111' aria-required="true" aria-invalid="false" ><option value='' >Select a Product</option><option value='Optics Products' >Optics Products</option><option value='X-ray Sources' >X-ray Sources</option><option value='X-ray Windows' >X-ray Windows</option><option value='X-ray Detectors' >X-ray Detectors</option></select></div></li><li id="field_1_83" class="gfield gplaceholder half dropdown first field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_83' >Referred By</label><div class='ginput_container ginput_container_select'><select name='input_83' id='input_1_83' class='medium gfield_select' tabindex='112' aria-invalid="false" ><option value='' >Referred By</option><option value='Tradeshow' >Tradeshow</option><option value='Word of Mouth' >Word of Mouth</option><option value='Magazine Ads' >Magazine Ads</option><option value='Conference' >Conference</option><option value='Web search' >Web search</option><option value='Other' >Other</option></select></div></li><li id="field_1_84" class="gfield gplaceholder half dropdown first field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_84' >Other</label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_1_84' type='text' value='' class='medium' tabindex='113' aria-invalid="false" /> </div></li><li id="field_1_117" class="gfield nofloat field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_117' >Attach Document</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_117' id='input_1_117' type='file' class='medium' aria-describedby="gfield_upload_rules_1_117" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='114' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_117'>Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, gif, tiff, dwg, Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_117'></div></div></li></ul>
</div>
<div class='gform_page_footer top_label'>
<input type='button' id='gform_next_button_1_43' class='gform_next_button button' value='Next' tabindex='115' onclick='jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); } ' />
</div>
</div>
<div id='gform_page_1_2' class='gform_page' style='display:none;'>
<div class='gform_page_fields'>
<ul id='gform_fields_1_2' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_44" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><p>Step 2 of 3: Product Selection</p></li><li id="field_1_14" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_14' >Product Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_1_14' class='large gfield_select' tabindex='116' aria-required="true" aria-invalid="false" ><option value='' >Select Option</option><option value='FBF04C High Contrast' >FBF04C High Contrast</option><option value='PPL04 High Contrast' >PPL04 High Contrast</option><option value='PPL05 Very High Transmission' >PPL05 Very High Transmission</option><option value='PBFF2A Standard' >PBFF2A Standard</option><option value='PBS02 Polarizing Beamsplitter' >PBS02 Polarizing Beamsplitter</option><option value='PBF02 Optically Flat PBS' >PBF02 Optically Flat PBS</option><option value='BIR04 IR High Contrast' >BIR04 IR High Contrast</option><option value='BIR05 Very High Transmission' >BIR05 Very High Transmission</option><option value='RCV6LCET High Transmission with protective Overcoat™' >RCV6LCET High Transmission with protective Overcoat™</option><option value='RCV6N2EC Ultra High Transmission' >RCV6N2EC Ultra High Transmission</option><option value='RCV8LCET High Contrast with protective Overcoat™' >RCV8LCET High Contrast with protective Overcoat™</option><option value='RCV8N2EC Balanced Transmission/Contrast' >RCV8N2EC Balanced Transmission/Contrast</option><option value='UBB01 Utlra Broadband' >UBB01 Utlra Broadband</option><option value='UCMNATC0 Narrow Band, Narrow AOI' >UCMNATC0 Narrow Band, Narrow AOI</option><option value='UVD240A High Contrast' >UVD240A High Contrast</option><option value='UVD260A High Contrast' >UVD260A High Contrast</option><option value='UVT240A High Transmission' >UVT240A High Transmission</option><option value='UVT260A High Transmission' >UVT260A High Transmission</option><option value='UVT300A High Transmission' >UVT300A High Transmission</option><option value='UVX240A, UVT240A + Coating' >UVX240A, UVT240A + Coating</option><option value='Absorptive Blue Transmission' >Absorptive Blue Transmission</option><option value='Absorptive Blue Contrast' >Absorptive Blue Contrast</option><option value='Absorptive Green Transmission' >Absorptive Green Transmission</option><option value='Absorptive Green Matched' >Absorptive Green Matched</option><option value='Absorptive Green Contrast' >Absorptive Green Contrast</option><option value='Absorptive Red Matched' >Absorptive Red Matched</option><option value='PFU04 Ultra High Contrast' >PFU04 Ultra High Contrast</option><option value='SIR 3-5 Broadband' >SIR 3-5 Broadband</option><option value='SIR 8-12 Broadband' >SIR 8-12 Broadband</option><option value='Pixelation' >Pixelation</option><option value='Standard Sample' >Standard Sample</option><option value='Custom Sample' >Custom Sample</option><option value='Sample Kit' >Sample Kit</option></select></div></li><li id="field_1_22" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_22' >Specific Wavelength Range (nm)</label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_1_22' type='text' value='' class='large' tabindex='117' aria-invalid="false" /> </div></li><li id="field_1_134" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_134' >Is Tp or Contrast Ratio more important?</label><div class='ginput_container ginput_container_select'><select name='input_134' id='input_1_134' class='large gfield_select' tabindex='118' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='Tp' >Tp</option><option value='Contrast' >Contrast</option></select></div></li><li id="field_1_15" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_15' >Product Shape<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_1_15' class='large gfield_select' tabindex='119' aria-required="true" aria-invalid="false" ><option value='' selected='selected'>Select Option</option><option value='Circle' >Circle</option><option value='Rectangle' >Rectangle</option><option value='Square' >Square</option><option value='Other' >Other</option></select></div></li><li id="field_1_13" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_13' >Dimension (X) in mm<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_1_13' type='text' value='' class='large' tabindex='120' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_16" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_16' >Dimension (Y) in mm<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_1_16' type='text' value='' class='large' tabindex='121' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_18" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_18' >X Dimensional Tolerance in mm: +/- 0.</label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_1_18' type='text' value='' class='large' tabindex='122' aria-invalid="false" /> </div></li><li id="field_1_19" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_19' >Y Dimensional Tolerance in mm: +/- 0.</label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_1_19' type='text' value='' class='large' tabindex='123' aria-invalid="false" /> </div></li><li id="field_1_20" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_20' >Transmission Axis (long side, degrees)</label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_1_20' type='text' value='' class='large' tabindex='124' aria-invalid="false" /> </div></li><li id="field_1_87" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_87' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_number'><input name='input_87' id='input_1_87' type='text' value='' class='medium' tabindex='125' aria-required="true" aria-invalid="false" /></div></li><li id="field_1_21" class="gfield gplaceholder attachment gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_21' >Visual Criteria<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_21' id='input_1_21' class='large gfield_select' tabindex='126' aria-required="true" aria-invalid="false" ><option value='' selected='selected'>Select Option</option><option value='VC0' >VC0</option><option value='VC1' >VC1</option><option value='VC2' >VC2</option><option value='VC4' >VC4</option><option value='VCIR' >VCIR</option><option value='Other' >Other</option></select></div></li><li id="field_1_23" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_23' >Edge Exclusion (mm)</label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_1_23' type='text' value='' class='large' tabindex='127' aria-invalid="false" /> </div></li><li id="field_1_131" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_131' >Additional Options</label><div class='ginput_container ginput_container_select'><select name='input_131' id='input_1_131' class='medium gfield_select' tabindex='128' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='Marking' >Marking</option><option value='Chamfer' >Chamfer</option><option value='Mounted Assembly' >Mounted Assembly</option><option value='Cover Glass' >Cover Glass</option><option value='Expedite (20% Fee)' >Expedite (20% Fee)</option></select></div></li><li id="field_1_135" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_135' >Product Requirements</label><div class='ginput_container ginput_container_select'><select name='input_135' id='input_1_135' class='large gfield_select' tabindex='129' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='ITAR Compliant' >ITAR Compliant</option><option value='Certificate of Conformance' >Certificate of Conformance</option><option value='Measurement Data' >Measurement Data</option><option value='First Article Inspection Report' >First Article Inspection Report</option><option value='Other' >Other</option></select></div></li><li id="field_1_148" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_148' >Other</label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_1_148' type='text' value='' class='medium' tabindex='130' aria-invalid="false" /> </div></li><li id="field_1_80" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_80' >X-ray Subject<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_1_80' class='medium gfield_select' tabindex='131' aria-required="true" aria-invalid="false" ><option value='40kv Magnum' >40kv Magnum</option><option value='50kv Magnum' >50kv Magnum</option><option value='FTC-200 Controller' >FTC-200 Controller</option><option value='XPIN-XT Detector' >XPIN-XT Detector</option><option value='XPIN-BT Detector' >XPIN-BT Detector</option><option value='Sealed Proprotional Counter' >Sealed Proprotional Counter</option><option value='MP103 Preamplifier' >MP103 Preamplifier</option><option value='AP3 Window' >AP3 Window</option><option value='AP5 Window' >AP5 Window</option><option value='ProLINE10 Windows' >ProLINE10 Windows</option><option value='ProLINE20 Windows' >ProLINE20 Windows</option><option value='Other' >Other</option></select></div></li><li id="field_1_79" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_79' >Other</label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_1_79' type='text' value='' class='medium' tabindex='132' aria-invalid="false" /> </div></li><li id="field_1_141" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_141' >X-ray Application</label><div class='ginput_container ginput_container_select'><select name='input_141' id='input_1_141' class='medium gfield_select' tabindex='133' aria-invalid="false" ><option value='Select Application' >Select Application</option><option value='XRF' >XRF</option><option value='XRD' >XRD</option><option value='Imaging' >Imaging</option><option value='Other' >Other</option></select></div></li><li id="field_1_58" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_58' >X-ray Sources</label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_1_58' class='medium gfield_select' tabindex='134' aria-invalid="false" ><option value='Select Type' >Select Type</option><option value='40kV/4W Cabled Transmission' >40kV/4W Cabled Transmission</option><option value='40kV/4W Cabled Reflection' >40kV/4W Cabled Reflection</option><option value='50kV/4W Transmission' >50kV/4W Transmission</option><option value='50kV/10W Cabled Transmission' >50kV/10W Cabled Transmission</option><option value='60kV/12W Transmission' >60kV/12W Transmission</option><option value='70kV/12W Transmission' >70kV/12W Transmission</option><option value='40kV FTC-200 Controller' >40kV FTC-200 Controller</option><option value='50kV FTC-200 Controller' >50kV FTC-200 Controller</option><option value='Other' >Other</option></select></div></li><li id="field_1_144" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/x-ray-products/x-ray-sources/end-window-monoblock.jpg" width="500" height="600"></li><li id="field_1_142" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_142' >Specify Product<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_142' id='input_1_142' type='text' value='' class='medium' tabindex='135' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_92" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_92' >40kV/4W Cabled Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_1_92' class='medium gfield_select' tabindex='136' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_145" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_145' >40kV/4W Cabled Reflection Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_145' id='input_1_145' class='medium gfield_select' tabindex='137' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Cr' >Cr</option><option value='Cu' >Cu</option><option value='Mo' >Mo</option><option value='W' >W</option></select></div></li><li id="field_1_96" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_96' >50kV/10W Cabled Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_96' id='input_1_96' class='medium gfield_select' tabindex='138' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Au' >Au</option><option value='Mo' >Mo</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_94" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_94' >50kV/4W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_94' id='input_1_94' class='medium gfield_select' tabindex='139' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Au' >Au</option><option value='Cr' >Cr</option><option value='Mo' >Mo</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_90" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_90' >60kV/12W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_90' id='input_1_90' class='medium gfield_select' tabindex='140' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Cr' >Cr</option><option value='Cu' >Cu</option><option value='Mo' >Mo</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_93" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_93' >70kV/12W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_93' id='input_1_93' class='medium gfield_select' tabindex='141' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Mo' >Mo</option><option value='W' >W</option><option value='Other' >Other</option></select></div></li><li id="field_1_57" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_57' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_1_57' type='text' value='' class='medium' tabindex='142' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_136" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_136' >Window Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_136' id='input_1_136' class='medium gfield_select' tabindex='143' aria-required="true" aria-invalid="false" ><option value='Select Window Type*' >Select Window Type*</option><option value='AP (Light Element)' >AP (Light Element)</option><option value='Beryllium' >Beryllium</option><option value='ProLINE' >ProLINE</option></select></div></li><li id="field_1_151" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_151' >Support Structure<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_151' id='input_1_151' class='medium gfield_select' tabindex='144' aria-required="true" aria-invalid="false" ><option value='Select Support Structure' >Select Support Structure</option><option value='ProLINE 10 (no support structure)' >ProLINE 10 (no support structure)</option><option value='ProLINE 20 (mesh support structure)' >ProLINE 20 (mesh support structure)</option></select></div></li><li id="field_1_152" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/ProLINE-Family.png"width="300"></li><li id="field_1_99" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_99' >Beryllium Thickness (µm)</label><div class='ginput_container ginput_container_select'><select name='input_99' id='input_1_99' class='large gfield_select' tabindex='145' aria-invalid="false" ><option value='Select Beryllium Thickness' >Select Beryllium Thickness</option><option value='8.0' >8.0</option><option value='12.0' >12.0</option><option value='25.0' >25.0</option><option value='Custom' >Custom</option></select></div></li><li id="field_1_63" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_63' >Custom Beryllium Thickness (µm)</label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_1_63' type='text' value='' class='medium' tabindex='146' aria-invalid="false" /> </div></li><li id="field_1_97" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_97' >Beryllium Diameter (mm)</label><div class='ginput_container ginput_container_select'><select name='input_97' id='input_1_97' class='medium gfield_select' tabindex='147' aria-invalid="false" ><option value='Select Beryllium Diameter' >Select Beryllium Diameter</option><option value='9.2' >9.2</option><option value='12.0' >12.0</option><option value='16.0' >16.0</option><option value='Custom' >Custom</option></select></div></li><li id="field_1_65" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_65' >Custom Beryllium Diameter (mm)</label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_1_65' type='text' value='' class='medium' tabindex='148' aria-invalid="false" /> </div></li><li id="field_1_100" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_100' >Window Attachment Options</label><div class='ginput_container ginput_container_select'><select name='input_100' id='input_1_100' class='large gfield_select' tabindex='149' aria-invalid="false" ><option value='Select Window Attachment Options' >Select Window Attachment Options</option><option value='No Attachment (U)' >No Attachment (U)</option><option value='Epoxied (Glue) (E)' >Epoxied (Glue) (E)</option><option value='Brazed (Metal Seal) (B)' >Brazed (Metal Seal) (B)</option></select></div></li><li id="field_1_95" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_95' >Beryllium Coating Options</label><div class='ginput_container ginput_container_select'><select name='input_95' id='input_1_95' class='large gfield_select' tabindex='150' aria-invalid="false" ><option value='Select Beryllium Coating Options' >Select Beryllium Coating Options</option><option value='No Coating (BE)' >No Coating (BE)</option><option value='DuraBeryllium (DB)' >DuraBeryllium (DB)</option><option value='DuraBeryllium Plus (DP)' >DuraBeryllium Plus (DP)</option></select></div></li><li id="field_1_137" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_137' >Window Size (Active Area mm²)</label><div class='ginput_container ginput_container_select'><select name='input_137' id='input_1_137' class='medium gfield_select' tabindex='151' aria-invalid="false" ><option value='Select Window Size' >Select Window Size</option><option value='10' >10</option><option value='20' >20</option><option value='30' >30</option><option value='50' >50</option><option value='80' >80</option><option value='100' >100</option><option value='140' >140</option></select></div></li><li id="field_1_139" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_139' >Film Thickness (Angstroms)</label><div class='ginput_container ginput_container_select'><select name='input_139' id='input_1_139' class='medium gfield_select' tabindex='152' aria-invalid="false" ><option value='Select Film Thickness' >Select Film Thickness</option><option value='1500' >1500</option><option value='3000' >3000</option><option value='6000' >6000</option><option value='12000' >12000</option></select></div></li><li id="field_1_140" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_140' >Aluminum Thickness (Angstroms)</label><div class='ginput_container ginput_container_select'><select name='input_140' id='input_1_140' class='large gfield_select' tabindex='153' aria-invalid="false" ><option value='Select Aluminum Thickness' >Select Aluminum Thickness</option><option value='No Aluminum' >No Aluminum</option><option value='100' >100</option><option value='300' >300</option><option value='450' >450</option></select></div></li><li id="field_1_138" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_138' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_1_138' type='text' value='' class='medium' tabindex='154' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_68" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_68' >Mount Drawing</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_68' id='input_1_68' type='file' class='medium' aria-describedby="gfield_upload_rules_1_68" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='155' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_68'>Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_68'></div></div></li><li id="field_1_128" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_128' >Detector Selection<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_128' id='input_1_128' class='medium gfield_select' tabindex='156' aria-required="true" aria-invalid="false" ><option value='Select Type' >Select Type</option><option value='XPIN-XT' >XPIN-XT</option><option value='XPIN-BT' >XPIN-BT</option><option value='MXDPP-50 OEM Version' >MXDPP-50 OEM Version</option><option value='MXDPP-50 End User Ready Version' >MXDPP-50 End User Ready Version</option></select></div></li><li id="field_1_147" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/xray-product/si-pin-x-ray-detectors/XPIN-BT-Detector.png" width="300"></li><li id="field_1_76" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_76' >Detector Active Area (mm²)</label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_1_76' class='medium gfield_select' tabindex='157' aria-invalid="false" ><option value='6' >6</option><option value='13' >13</option></select></div></li><li id="field_1_74" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_74' >Assembly Options</label><div class='ginput_container ginput_container_select'><select name='input_74' id='input_1_74' class='medium gfield_select' tabindex='158' aria-invalid="false" ><option value='None' >None</option><option value='Angle Bracket' >Angle Bracket</option><option value='Heat Sink' >Heat Sink</option></select></div></li><li id="field_1_75" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_75' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_1_75' type='text' value='' class='medium' tabindex='159' aria-required="true" aria-invalid="false" /> </div></li></ul>
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<div class='gform_page_footer top_label'>
<input type='button' id='gform_previous_button_1_45' class='gform_previous_button button' value='Previous' tabindex='160' onclick='jQuery("#gform_target_page_number_1").val("1"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("1"); jQuery("#gform_1").trigger("submit",[true]); } ' /> <input type='button' id='gform_next_button_1_45' class='gform_next_button button' value='Next' tabindex='161' onclick='jQuery("#gform_target_page_number_1").val("3"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("3"); jQuery("#gform_1").trigger("submit",[true]); } ' />
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<div id='gform_page_1_3' class='gform_page' style='display:none;'>
<div class='gform_page_fields'>
<ul id='gform_fields_1_3' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_150" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><p>Step 3 of 3: Additional Information</p></li><li id="field_1_149" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ></li><li id="field_1_47" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_47' >When do you expect to place an order?</label><div class='ginput_container ginput_container_date'>
<input name='input_47' id='input_1_47' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon' tabindex='162' placeholder='mm/dd/yyyy' aria-describedby="input_1_47_date_format" aria-invalid="false" />
<span id='input_1_47_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span>
</div>
<input type='hidden' id='gforms_calendar_icon_input_1_47' class='gform_hidden' value='/wp-content/themes/moxtek/images/icon-date-picker.png'/></li><li id="field_1_48" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_48' >What is the application?</label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_1_48' type='text' value='' class='medium' tabindex='163' aria-invalid="false" /> </div></li><li id="field_1_49" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_49' >What is the target market?</label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_1_49' type='text' value='' class='medium' tabindex='164' aria-invalid="false" /> </div></li><li id="field_1_52" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_52' >What is the annual forecast?</label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_1_52' type='text' value='' class='medium' tabindex='165' aria-invalid="false" /> </div></li><li id="field_1_53" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_53' >Where will the application be manufactured?</label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_1_53' type='text' value='' class='medium' tabindex='166' aria-invalid="false" /> </div></li><li id="field_1_112" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_112' >Customer Part ID (If Applicable)</label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_1_112' type='text' value='' class='large' tabindex='167' aria-invalid="false" /> </div></li><li id="field_1_50" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_50' >Is this product in production?</label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_1_50' class='medium gfield_select' tabindex='168' aria-invalid="false" ><option value='' ></option><option value='No' >No</option><option value='Yes' >Yes</option></select></div></li><li id="field_1_51" class="gfield floatright field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_51' >If not in production, when will it be launched?</label><div class='ginput_container ginput_container_date'>
<input name='input_51' id='input_1_51' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon' tabindex='169' placeholder='mm/dd/yyyy' aria-describedby="input_1_51_date_format" aria-invalid="false" />
<span id='input_1_51_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span>
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<input type='hidden' id='gforms_calendar_icon_input_1_51' class='gform_hidden' value='/wp-content/themes/moxtek/images/icon-date-picker.png'/></li><li id="field_1_25" class="gfield nofloat field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_25' >Attach Document Below</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_25' id='input_1_25' type='file' class='medium' aria-describedby="gfield_upload_rules_1_25" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='170' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_25'>Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, gif, tiff, dwg, Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_25'></div></div></li><li id="field_1_115" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_115' >Mount Drawing</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_115' id='input_1_115' type='file' class='medium' aria-describedby="gfield_upload_rules_1_115" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='171' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_115'>Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_115'></div></div></li><li id="field_1_37" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_37' >Labeling, Packaging and other Special Requirements</label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_1_37' class='textarea medium' tabindex='172' aria-invalid="false" rows='10' cols='50'></textarea></div></li><li id="field_1_113" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label screen-reader-text' for='input_1_113' ></label><div id='input_1_113' class='ginput_container ginput_recaptcha' data-sitekey='6LcNL8QaAAAAADXKiQjVtmPJV5aO-rRuCMyQ057d' data-theme='light' data-tabindex='-1' data-size='invisible' data-badge='bottomright'></div></li><li id="field_1_146" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ></li><li id="field_1_153" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_153' >Email</label><div class='ginput_container'><input name='input_153' id='input_1_153' type='text' value='' /></div><div class='gfield_description' id='gfield_description_1_153'>This field is for validation purposes and should be left unchanged.</div></li></ul></div>
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<input type='hidden' class='gform_hidden' name='is_submit_1' value='1' />
<input type='hidden' class='gform_hidden' name='gform_submit' value='1' />
<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
<input type='hidden' class='gform_hidden' name='state_1' value='WyJbXSIsIjI4ZTM1OWM3OWE4MzlkOWU1NDgxOGZmMzMxMWYxYTlhIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='2' />
<input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' />
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<script type="text/javascript">
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<div id="consult-experts" class="formStyle">
<div class="heading2">Consult Our Experts</div>
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<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_4' ><div id='gf_4' class='gform_anchor' tabindex='-1'></div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_4' id='gform_4' action='/legal/patent-documents/#gf_4' >
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</div></li><li id="field_4_4" class="gfield half first gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_4_4' >Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_4_4' type='text' value='' class='medium' tabindex='203' aria-required="true" aria-invalid="false" /></div></li><li id="field_4_11" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_4_11' >Area of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_4_11' class='medium gfield_select' tabindex='204' aria-required="true" aria-invalid="false" ><option value='Select Area of Interest' >Select Area of Interest</option><option value='Optics' >Optics</option><option value='X-ray' >X-ray</option><option value='Core Technology' >Core Technology</option><option value='Partnership' >Partnership</option></select></div></li><li id="field_4_6" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_4_6' >Message<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_4_6' class='textarea medium' tabindex='205' aria-required="true" aria-invalid="false" rows='10' cols='50'></textarea></div></li><li id="field_4_7" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><p>For details about Moxtek employment opportunities, please visit the <a href="https://moxtek.applicantpro.com/jobs/">Careers</a> page</p></li><li id="field_4_8" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label screen-reader-text' for='input_4_8' ></label><div id='input_4_8' class='ginput_container ginput_recaptcha' data-sitekey='6LcNL8QaAAAAADXKiQjVtmPJV5aO-rRuCMyQ057d' data-theme='light' data-tabindex='-1' data-size='invisible' data-badge='bottomright'></div></li><li id="field_4_12" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_4_12' >Comments</label><div class='ginput_container'><input name='input_12' id='input_4_12' type='text' value='' /></div><div class='gfield_description' id='gfield_description_4_12'>This field is for validation purposes and should be left unchanged.</div></li></ul></div>
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<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
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<input type='hidden' class='gform_hidden' name='gform_source_page_number_4' id='gform_source_page_number_4' value='1' />
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<iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_4' id='gform_ajax_frame_4' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe>
<script type="text/javascript">
gform.initializeOnLoaded( function() {gformInitSpinner( 4, 'https://moxtek.com/wp-content/plugins/gravityforms/images/spinner.svg' );jQuery('#gform_ajax_frame_4').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_4');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_4').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_4').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_4').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_4').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_4').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_4').val();gformInitSpinner( 4, 'https://moxtek.com/wp-content/plugins/gravityforms/images/spinner.svg' );jQuery(document).trigger('gform_page_loaded', [4, current_page]);window['gf_submitting_4'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_4').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_4').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [4]);window['gf_submitting_4'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_4').text());}, 50);}else{jQuery('#gform_4').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [4, current_page]);} );} );
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<div id="request-a-quote" class="uk-flex-top" uk-modal>
<div class="uk-modal-dialog uk-modal-body uk-margin-auto-vertical">
<button class="uk-modal-close-default" type="button" uk-close></button>
<div class="uk-modal-body" uk-overflow-auto>
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<div id='gf_progressbar_wrapper_1' class='gf_progressbar_wrapper'>
<h3 class="gf_progressbar_title">Step <span class='gf_step_current_page'>1</span> of <span class='gf_step_page_count'>3</span>
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<span id='input_1_4_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span>
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<input type='hidden' id='gforms_calendar_icon_input_1_4' class='gform_hidden' value='/wp-content/themes/moxtek/images/icon-date-picker.png'/></li><li id="field_1_5" class="gfield gplaceholder half first gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_5' >Company<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_1_5' type='text' value='' class='large' tabindex='101' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_123" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_123' >First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_123' id='input_1_123' type='text' value='' class='large' tabindex='102' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_119" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_119' >Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_1_119' type='text' value='' class='large' tabindex='103' placeholder='Last Name' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_88" class="gfield gplaceholder half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_88' >Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_88' id='input_1_88' type='text' value='' class='large' tabindex='104' aria-required="true" aria-invalid="false" /></div></li><li id="field_1_81" class="gfield gplaceholder half field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_81' >Street Address</label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_1_81' type='text' value='' class='large' tabindex='105' aria-invalid="false" /> </div></li><li id="field_1_86" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_86' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
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class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_1_9' class='large gfield_select' tabindex='109' aria-required="true" aria-invalid="false" ><option value='' >Country *</option><option value='United States' >United States</option><option value='United Kingdom' >United Kingdom</option><option value='China' >China</option><option value='Germany' >Germany</option><option value='Japan' >Japan</option><option value='Russia' >Russia</option><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Brazil' >Brazil</option><option value='Brunei' >Brunei</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cape Verde' >Cape Verde</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Congo, Republic of the' >Congo, Republic of the</option><option value='Costa Rica' >Costa Rica</option><option value='Côte d'Ivoire' >Côte d'Ivoire</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Cyprus' >Cyprus</option><option value='Czech Republic' >Czech Republic</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='East Timor' >East Timor</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Ethiopia' >Ethiopia</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='North Korea' >North Korea</option><option value='South Korea' >South Korea</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Laos' >Laos</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macedonia' >Macedonia</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Norway' >Norway</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine' >Palestine</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russia' >Russia</option><option value='Rwanda' >Rwanda</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia and Montenegro' >Serbia and Montenegro</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Sudan, South' >Sudan, South</option><option value='Suriname' >Suriname</option><option value='Swaziland' >Swaziland</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria' >Syria</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania' >Tanzania</option><option value='Thailand' >Thailand</option><option value='Togo' >Togo</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkey' >Turkey</option><option value='Turkmenistan' >Turkmenistan</option><option value='Tuvalu' >Tuvalu</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' >United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Vatican City' >Vatican City</option><option value='Venezuela' >Venezuela</option><option value='Vietnam' >Vietnam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option></select></div></li><li id="field_1_41" class="gfield gplaceholder half first gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_41' >Postal Code<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_1_41' type='text' value='' class='large' tabindex='110' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_55" class="gfield gplaceholder half dropdown last gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_55' >Product Group<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_1_55' class='medium gfield_select' tabindex='111' aria-required="true" aria-invalid="false" ><option value='' >Select a Product</option><option value='Optics Products' >Optics Products</option><option value='X-ray Sources' >X-ray Sources</option><option value='X-ray Windows' >X-ray Windows</option><option value='X-ray Detectors' >X-ray Detectors</option></select></div></li><li id="field_1_83" class="gfield gplaceholder half dropdown first field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_83' >Referred By</label><div class='ginput_container ginput_container_select'><select name='input_83' id='input_1_83' class='medium gfield_select' tabindex='112' aria-invalid="false" ><option value='' >Referred By</option><option value='Tradeshow' >Tradeshow</option><option value='Word of Mouth' >Word of Mouth</option><option value='Magazine Ads' >Magazine Ads</option><option value='Conference' >Conference</option><option value='Web search' >Web search</option><option value='Other' >Other</option></select></div></li><li id="field_1_84" class="gfield gplaceholder half dropdown first field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_84' >Other</label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_1_84' type='text' value='' class='medium' tabindex='113' aria-invalid="false" /> </div></li><li id="field_1_117" class="gfield nofloat field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_117' >Attach Document</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_117' id='input_1_117' type='file' class='medium' aria-describedby="gfield_upload_rules_1_117" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='114' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_117'>Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, gif, tiff, dwg, Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_117'></div></div></li></ul>
</div>
<div class='gform_page_footer top_label'>
<input type='button' id='gform_next_button_1_43' class='gform_next_button button' value='Next' tabindex='115' onclick='jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); } ' />
</div>
</div>
<div id='gform_page_1_2' class='gform_page' style='display:none;'>
<div class='gform_page_fields'>
<ul id='gform_fields_1_2' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_44" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><p>Step 2 of 3: Product Selection</p></li><li id="field_1_14" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_14' >Product Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_1_14' class='large gfield_select' tabindex='116' aria-required="true" aria-invalid="false" ><option value='' >Select Option</option><option value='FBF04C High Contrast' >FBF04C High Contrast</option><option value='PPL04 High Contrast' >PPL04 High Contrast</option><option value='PPL05 Very High Transmission' >PPL05 Very High Transmission</option><option value='PBFF2A Standard' >PBFF2A Standard</option><option value='PBS02 Polarizing Beamsplitter' >PBS02 Polarizing Beamsplitter</option><option value='PBF02 Optically Flat PBS' >PBF02 Optically Flat PBS</option><option value='BIR04 IR High Contrast' >BIR04 IR High Contrast</option><option value='BIR05 Very High Transmission' >BIR05 Very High Transmission</option><option value='RCV6LCET High Transmission with protective Overcoat™' >RCV6LCET High Transmission with protective Overcoat™</option><option value='RCV6N2EC Ultra High Transmission' >RCV6N2EC Ultra High Transmission</option><option value='RCV8LCET High Contrast with protective Overcoat™' >RCV8LCET High Contrast with protective Overcoat™</option><option value='RCV8N2EC Balanced Transmission/Contrast' >RCV8N2EC Balanced Transmission/Contrast</option><option value='UBB01 Utlra Broadband' >UBB01 Utlra Broadband</option><option value='UCMNATC0 Narrow Band, Narrow AOI' >UCMNATC0 Narrow Band, Narrow AOI</option><option value='UVD240A High Contrast' >UVD240A High Contrast</option><option value='UVD260A High Contrast' >UVD260A High Contrast</option><option value='UVT240A High Transmission' >UVT240A High Transmission</option><option value='UVT260A High Transmission' >UVT260A High Transmission</option><option value='UVT300A High Transmission' >UVT300A High Transmission</option><option value='UVX240A, UVT240A + Coating' >UVX240A, UVT240A + Coating</option><option value='Absorptive Blue Transmission' >Absorptive Blue Transmission</option><option value='Absorptive Blue Contrast' >Absorptive Blue Contrast</option><option value='Absorptive Green Transmission' >Absorptive Green Transmission</option><option value='Absorptive Green Matched' >Absorptive Green Matched</option><option value='Absorptive Green Contrast' >Absorptive Green Contrast</option><option value='Absorptive Red Matched' >Absorptive Red Matched</option><option value='PFU04 Ultra High Contrast' >PFU04 Ultra High Contrast</option><option value='SIR 3-5 Broadband' >SIR 3-5 Broadband</option><option value='SIR 8-12 Broadband' >SIR 8-12 Broadband</option><option value='Pixelation' >Pixelation</option><option value='Standard Sample' >Standard Sample</option><option value='Custom Sample' >Custom Sample</option><option value='Sample Kit' >Sample Kit</option></select></div></li><li id="field_1_22" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_22' >Specific Wavelength Range (nm)</label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_1_22' type='text' value='' class='large' tabindex='117' aria-invalid="false" /> </div></li><li id="field_1_134" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_134' >Is Tp or Contrast Ratio more important?</label><div class='ginput_container ginput_container_select'><select name='input_134' id='input_1_134' class='large gfield_select' tabindex='118' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='Tp' >Tp</option><option value='Contrast' >Contrast</option></select></div></li><li id="field_1_15" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_15' >Product Shape<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_1_15' class='large gfield_select' tabindex='119' aria-required="true" aria-invalid="false" ><option value='' selected='selected'>Select Option</option><option value='Circle' >Circle</option><option value='Rectangle' >Rectangle</option><option value='Square' >Square</option><option value='Other' >Other</option></select></div></li><li id="field_1_13" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_13' >Dimension (X) in mm<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_1_13' type='text' value='' class='large' tabindex='120' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_16" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_16' >Dimension (Y) in mm<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_1_16' type='text' value='' class='large' tabindex='121' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_18" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_18' >X Dimensional Tolerance in mm: +/- 0.</label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_1_18' type='text' value='' class='large' tabindex='122' aria-invalid="false" /> </div></li><li id="field_1_19" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_19' >Y Dimensional Tolerance in mm: +/- 0.</label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_1_19' type='text' value='' class='large' tabindex='123' aria-invalid="false" /> </div></li><li id="field_1_20" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_20' >Transmission Axis (long side, degrees)</label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_1_20' type='text' value='' class='large' tabindex='124' aria-invalid="false" /> </div></li><li id="field_1_87" class="gfield gplaceholder gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_87' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_number'><input name='input_87' id='input_1_87' type='text' value='' class='medium' tabindex='125' aria-required="true" aria-invalid="false" /></div></li><li id="field_1_21" class="gfield gplaceholder attachment gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_21' >Visual Criteria<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_21' id='input_1_21' class='large gfield_select' tabindex='126' aria-required="true" aria-invalid="false" ><option value='' selected='selected'>Select Option</option><option value='VC0' >VC0</option><option value='VC1' >VC1</option><option value='VC2' >VC2</option><option value='VC4' >VC4</option><option value='VCIR' >VCIR</option><option value='Other' >Other</option></select></div></li><li id="field_1_23" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_23' >Edge Exclusion (mm)</label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_1_23' type='text' value='' class='large' tabindex='127' aria-invalid="false" /> </div></li><li id="field_1_131" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_131' >Additional Options</label><div class='ginput_container ginput_container_select'><select name='input_131' id='input_1_131' class='medium gfield_select' tabindex='128' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='Marking' >Marking</option><option value='Chamfer' >Chamfer</option><option value='Mounted Assembly' >Mounted Assembly</option><option value='Cover Glass' >Cover Glass</option><option value='Expedite (20% Fee)' >Expedite (20% Fee)</option></select></div></li><li id="field_1_135" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_135' >Product Requirements</label><div class='ginput_container ginput_container_select'><select name='input_135' id='input_1_135' class='large gfield_select' tabindex='129' aria-invalid="false" ><option value='Select Option' >Select Option</option><option value='ITAR Compliant' >ITAR Compliant</option><option value='Certificate of Conformance' >Certificate of Conformance</option><option value='Measurement Data' >Measurement Data</option><option value='First Article Inspection Report' >First Article Inspection Report</option><option value='Other' >Other</option></select></div></li><li id="field_1_148" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_148' >Other</label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_1_148' type='text' value='' class='medium' tabindex='130' aria-invalid="false" /> </div></li><li id="field_1_80" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_80' >X-ray Subject<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_1_80' class='medium gfield_select' tabindex='131' aria-required="true" aria-invalid="false" ><option value='40kv Magnum' >40kv Magnum</option><option value='50kv Magnum' >50kv Magnum</option><option value='FTC-200 Controller' >FTC-200 Controller</option><option value='XPIN-XT Detector' >XPIN-XT Detector</option><option value='XPIN-BT Detector' >XPIN-BT Detector</option><option value='Sealed Proprotional Counter' >Sealed Proprotional Counter</option><option value='MP103 Preamplifier' >MP103 Preamplifier</option><option value='AP3 Window' >AP3 Window</option><option value='AP5 Window' >AP5 Window</option><option value='ProLINE10 Windows' >ProLINE10 Windows</option><option value='ProLINE20 Windows' >ProLINE20 Windows</option><option value='Other' >Other</option></select></div></li><li id="field_1_79" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_79' >Other</label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_1_79' type='text' value='' class='medium' tabindex='132' aria-invalid="false" /> </div></li><li id="field_1_141" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_141' >X-ray Application</label><div class='ginput_container ginput_container_select'><select name='input_141' id='input_1_141' class='medium gfield_select' tabindex='133' aria-invalid="false" ><option value='Select Application' >Select Application</option><option value='XRF' >XRF</option><option value='XRD' >XRD</option><option value='Imaging' >Imaging</option><option value='Other' >Other</option></select></div></li><li id="field_1_58" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_58' >X-ray Sources</label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_1_58' class='medium gfield_select' tabindex='134' aria-invalid="false" ><option value='Select Type' >Select Type</option><option value='40kV/4W Cabled Transmission' >40kV/4W Cabled Transmission</option><option value='40kV/4W Cabled Reflection' >40kV/4W Cabled Reflection</option><option value='50kV/4W Transmission' >50kV/4W Transmission</option><option value='50kV/10W Cabled Transmission' >50kV/10W Cabled Transmission</option><option value='60kV/12W Transmission' >60kV/12W Transmission</option><option value='70kV/12W Transmission' >70kV/12W Transmission</option><option value='40kV FTC-200 Controller' >40kV FTC-200 Controller</option><option value='50kV FTC-200 Controller' >50kV FTC-200 Controller</option><option value='Other' >Other</option></select></div></li><li id="field_1_144" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/x-ray-products/x-ray-sources/end-window-monoblock.jpg" width="500" height="600"></li><li id="field_1_142" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_142' >Specify Product<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_142' id='input_1_142' type='text' value='' class='medium' tabindex='135' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_92" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_92' >40kV/4W Cabled Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_1_92' class='medium gfield_select' tabindex='136' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_145" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_145' >40kV/4W Cabled Reflection Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_145' id='input_1_145' class='medium gfield_select' tabindex='137' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Cr' >Cr</option><option value='Cu' >Cu</option><option value='Mo' >Mo</option><option value='W' >W</option></select></div></li><li id="field_1_96" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_96' >50kV/10W Cabled Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_96' id='input_1_96' class='medium gfield_select' tabindex='138' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Au' >Au</option><option value='Mo' >Mo</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_94" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_94' >50kV/4W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_94' id='input_1_94' class='medium gfield_select' tabindex='139' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Au' >Au</option><option value='Cr' >Cr</option><option value='Mo' >Mo</option><option value='Pd' >Pd</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_90" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_90' >60kV/12W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_90' id='input_1_90' class='medium gfield_select' tabindex='140' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Ag' >Ag</option><option value='Cr' >Cr</option><option value='Cu' >Cu</option><option value='Mo' >Mo</option><option value='Rh' >Rh</option><option value='W' >W</option></select></div></li><li id="field_1_93" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_93' >70kV/12W Transmission Target<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_93' id='input_1_93' class='medium gfield_select' tabindex='141' aria-required="true" aria-invalid="false" ><option value='Select Target' >Select Target</option><option value='Mo' >Mo</option><option value='W' >W</option><option value='Other' >Other</option></select></div></li><li id="field_1_57" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_57' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_1_57' type='text' value='' class='medium' tabindex='142' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_136" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_136' >Window Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_136' id='input_1_136' class='medium gfield_select' tabindex='143' aria-required="true" aria-invalid="false" ><option value='Select Window Type*' >Select Window Type*</option><option value='AP (Light Element)' >AP (Light Element)</option><option value='Beryllium' >Beryllium</option><option value='ProLINE' >ProLINE</option></select></div></li><li id="field_1_151" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_151' >Support Structure<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_151' id='input_1_151' class='medium gfield_select' tabindex='144' aria-required="true" aria-invalid="false" ><option value='Select Support Structure' >Select Support Structure</option><option value='ProLINE 10 (no support structure)' >ProLINE 10 (no support structure)</option><option value='ProLINE 20 (mesh support structure)' >ProLINE 20 (mesh support structure)</option></select></div></li><li id="field_1_152" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/ProLINE-Family.png"width="300"></li><li id="field_1_99" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_99' >Beryllium Thickness (µm)</label><div class='ginput_container ginput_container_select'><select name='input_99' id='input_1_99' class='large gfield_select' tabindex='145' aria-invalid="false" ><option value='Select Beryllium Thickness' >Select Beryllium Thickness</option><option value='8.0' >8.0</option><option value='12.0' >12.0</option><option value='25.0' >25.0</option><option value='Custom' >Custom</option></select></div></li><li id="field_1_63" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_63' >Custom Beryllium Thickness (µm)</label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_1_63' type='text' value='' class='medium' tabindex='146' aria-invalid="false" /> </div></li><li id="field_1_97" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_97' >Beryllium Diameter (mm)</label><div class='ginput_container ginput_container_select'><select name='input_97' id='input_1_97' class='medium gfield_select' tabindex='147' aria-invalid="false" ><option value='Select Beryllium Diameter' >Select Beryllium Diameter</option><option value='9.2' >9.2</option><option value='12.0' >12.0</option><option value='16.0' >16.0</option><option value='Custom' >Custom</option></select></div></li><li id="field_1_65" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_65' >Custom Beryllium Diameter (mm)</label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_1_65' type='text' value='' class='medium' tabindex='148' aria-invalid="false" /> </div></li><li id="field_1_100" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_100' >Window Attachment Options</label><div class='ginput_container ginput_container_select'><select name='input_100' id='input_1_100' class='large gfield_select' tabindex='149' aria-invalid="false" ><option value='Select Window Attachment Options' >Select Window Attachment Options</option><option value='No Attachment (U)' >No Attachment (U)</option><option value='Epoxied (Glue) (E)' >Epoxied (Glue) (E)</option><option value='Brazed (Metal Seal) (B)' >Brazed (Metal Seal) (B)</option></select></div></li><li id="field_1_95" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_95' >Beryllium Coating Options</label><div class='ginput_container ginput_container_select'><select name='input_95' id='input_1_95' class='large gfield_select' tabindex='150' aria-invalid="false" ><option value='Select Beryllium Coating Options' >Select Beryllium Coating Options</option><option value='No Coating (BE)' >No Coating (BE)</option><option value='DuraBeryllium (DB)' >DuraBeryllium (DB)</option><option value='DuraBeryllium Plus (DP)' >DuraBeryllium Plus (DP)</option></select></div></li><li id="field_1_137" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_137' >Window Size (Active Area mm²)</label><div class='ginput_container ginput_container_select'><select name='input_137' id='input_1_137' class='medium gfield_select' tabindex='151' aria-invalid="false" ><option value='Select Window Size' >Select Window Size</option><option value='10' >10</option><option value='20' >20</option><option value='30' >30</option><option value='50' >50</option><option value='80' >80</option><option value='100' >100</option><option value='140' >140</option></select></div></li><li id="field_1_139" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_139' >Film Thickness (Angstroms)</label><div class='ginput_container ginput_container_select'><select name='input_139' id='input_1_139' class='medium gfield_select' tabindex='152' aria-invalid="false" ><option value='Select Film Thickness' >Select Film Thickness</option><option value='1500' >1500</option><option value='3000' >3000</option><option value='6000' >6000</option><option value='12000' >12000</option></select></div></li><li id="field_1_140" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_140' >Aluminum Thickness (Angstroms)</label><div class='ginput_container 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gfield_select' tabindex='156' aria-required="true" aria-invalid="false" ><option value='Select Type' >Select Type</option><option value='XPIN-XT' >XPIN-XT</option><option value='XPIN-BT' >XPIN-BT</option><option value='MXDPP-50 OEM Version' >MXDPP-50 OEM Version</option><option value='MXDPP-50 End User Ready Version' >MXDPP-50 End User Ready Version</option></select></div></li><li id="field_1_147" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><img src="https://moxtek.com/wp-content/uploads/xray-product/si-pin-x-ray-detectors/XPIN-BT-Detector.png" width="300"></li><li id="field_1_76" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_76' >Detector Active Area (mm²)</label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_1_76' class='medium gfield_select' tabindex='157' aria-invalid="false" ><option value='6' >6</option><option value='13' >13</option></select></div></li><li id="field_1_74" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_74' >Assembly Options</label><div class='ginput_container ginput_container_select'><select name='input_74' id='input_1_74' class='medium gfield_select' tabindex='158' aria-invalid="false" ><option value='None' >None</option><option value='Angle Bracket' >Angle Bracket</option><option value='Heat Sink' >Heat Sink</option></select></div></li><li id="field_1_75" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_75' >Quantity<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_1_75' type='text' value='' class='medium' tabindex='159' aria-required="true" aria-invalid="false" /> </div></li></ul>
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<div class='gform_page_footer top_label'>
<input type='button' id='gform_previous_button_1_45' class='gform_previous_button button' value='Previous' tabindex='160' onclick='jQuery("#gform_target_page_number_1").val("1"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("1"); jQuery("#gform_1").trigger("submit",[true]); } ' /> <input type='button' id='gform_next_button_1_45' class='gform_next_button button' value='Next' tabindex='161' onclick='jQuery("#gform_target_page_number_1").val("3"); jQuery("#gform_1").trigger("submit",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("3"); jQuery("#gform_1").trigger("submit",[true]); } ' />
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<div class='gform_page_fields'>
<ul id='gform_fields_1_3' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_150" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ><p>Step 3 of 3: Additional Information</p></li><li id="field_1_149" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ></li><li id="field_1_47" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_47' >When do you expect to place an order?</label><div class='ginput_container ginput_container_date'>
<input name='input_47' id='input_1_47' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon' tabindex='162' placeholder='mm/dd/yyyy' aria-describedby="input_1_47_date_format" aria-invalid="false" />
<span id='input_1_47_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span>
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<input type='hidden' id='gforms_calendar_icon_input_1_47' class='gform_hidden' value='/wp-content/themes/moxtek/images/icon-date-picker.png'/></li><li id="field_1_48" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_48' >What is the application?</label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_1_48' type='text' value='' class='medium' tabindex='163' aria-invalid="false" /> </div></li><li id="field_1_49" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_49' >What is the target market?</label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_1_49' type='text' value='' class='medium' tabindex='164' aria-invalid="false" /> </div></li><li id="field_1_52" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_52' >What is the annual forecast?</label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_1_52' type='text' value='' class='medium' tabindex='165' aria-invalid="false" /> </div></li><li id="field_1_53" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_53' >Where will the application be manufactured?</label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_1_53' type='text' value='' class='medium' tabindex='166' aria-invalid="false" /> </div></li><li id="field_1_112" class="gfield gplaceholder field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_112' >Customer Part ID (If Applicable)</label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_1_112' type='text' value='' class='large' tabindex='167' aria-invalid="false" /> </div></li><li id="field_1_50" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_50' >Is this product in production?</label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_1_50' class='medium gfield_select' tabindex='168' aria-invalid="false" ><option value='' ></option><option value='No' >No</option><option value='Yes' >Yes</option></select></div></li><li id="field_1_51" class="gfield floatright field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_51' >If not in production, when will it be launched?</label><div class='ginput_container ginput_container_date'>
<input name='input_51' id='input_1_51' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon' tabindex='169' placeholder='mm/dd/yyyy' aria-describedby="input_1_51_date_format" aria-invalid="false" />
<span id='input_1_51_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span>
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<input type='hidden' id='gforms_calendar_icon_input_1_51' class='gform_hidden' value='/wp-content/themes/moxtek/images/icon-date-picker.png'/></li><li id="field_1_25" class="gfield nofloat field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_25' >Attach Document Below</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_25' id='input_1_25' type='file' class='medium' aria-describedby="gfield_upload_rules_1_25" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='170' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_25'>Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, gif, tiff, dwg, Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_25'></div></div></li><li id="field_1_115" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_115' >Mount Drawing</label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10485760' /><input name='input_115' id='input_1_115' type='file' class='medium' aria-describedby="gfield_upload_rules_1_115" onchange='javascript:gformValidateFileSize( this, 10485760 );' tabindex='171' /><span class='gform_fileupload_rules' id='gfield_upload_rules_1_115'>Max. file size: 10 MB.</span><div class='validation_message validation_message--hidden-on-empty' id='live_validation_message_1_115'></div></div></li><li id="field_1_37" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_37' >Labeling, Packaging and other Special Requirements</label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_1_37' class='textarea medium' tabindex='172' aria-invalid="false" rows='10' cols='50'></textarea></div></li><li id="field_1_113" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label screen-reader-text' for='input_1_113' ></label><div id='input_1_113' class='ginput_container ginput_recaptcha' data-sitekey='6LcNL8QaAAAAADXKiQjVtmPJV5aO-rRuCMyQ057d' data-theme='light' data-tabindex='-1' data-size='invisible' data-badge='bottomright'></div></li><li id="field_1_146" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" ></li><li id="field_1_153" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_1_153' >Email</label><div class='ginput_container'><input name='input_153' id='input_1_153' type='text' value='' /></div><div class='gfield_description' id='gfield_description_1_153'>This field is for validation purposes and should be left unchanged.</div></li></ul></div>
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<iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_1' id='gform_ajax_frame_1' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe>
<script type="text/javascript">
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<div id="consult-our-experts" class="uk-flex-top" uk-modal>
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<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_4' ><div id='gf_4' class='gform_anchor' tabindex='-1'></div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_4' id='gform_4' action='/legal/patent-documents/#gf_4' >
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