Super Capacitor Module (SCM) Questionnaire (Information required for initial evaluation) Customer Address City Contact Contact Title Email Phone State Zip Date Project/ Application name Application description EAU Maximum voltage (Vmax) applied to module Minimum voltage (Vmin) needed for system to operate (Should be greater than or equal to 0.5*Vmax) Power requirement or Current (Continuous) Current (Maximum/Peak) Discharge time (Length of time power needed while still above Minimum voltage.) Capacitance (Typically calculated. Only required if power or discharge time are not known.) Maximum dimensions (If size is critical.) Target Price Additional Comments: Volts DC Volts DC Watts Amps Amps Seconds Farads LxWxT (mm) $ USD