Sales DPT

Product Request Form

(special conditions)

In case that you need us to help you with choosing the right product, please fill out this form 

  • For your own benefit, please complete the following form carefully and submit to our sales department.Feel free to contact us if you have any question.

Pump Selection Form

1.Personal Information

First Name *
Last Name *
City *
State *
Country *
ZIP Code *
Address *
Company Name
Email *
Phone Number *
Fax Number

2.Pump Information

Required Head Pressure(ft | PSI | Meters) *
Required Flow(GPM | m3/h | lpm) *
Installation Method *
Phase *
Voltage(V) *
Frequency (50/60Hz) *
Other Special Conditions:
Pump Application (Please explain with details) *
Protections System *
Pump Daily Operation Time *

3.Additional Information

Fluid Name
Fluid Viscosity
Fluid PH
Fluid Density
Fluid Temperature
Ambient Temperature 
Pump Material

IMPORTANT NOTICE: Gol Pumps Technology Company can help their customers to choose the most suitable pump for a specific matter. If you need our opinion, please fill out this form carefully and send for us. Otherwise, you may consult with your preferred engineer, before choosing any of our products. Gol Pumps Technology Company declines any responsibility about this guidance.

⇓⇓ Download The PDF form here ⇓⇓

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