Horizontal Coupling Quotation Form

Complete the online quote form below now and press “Submit”. Note: Please press “Submit” at the bottom of the form to save and send form data. We will review the data and contact you within 24 hours.

Or you can download and complete a Horizontal Application Data Sheet quotation form. Fax (717) 428-2865 or email it to us at sales@couplingcorp.com.

Horizontal Application

• Company Name*
• Contact Name*
  First Last
• Phone*
• Email*
• Address
  Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country
• Proposal Needed By
  MM slash DD slash YYYY
• Coupling Needed By
  MM slash DD slash YYYY
• Power
• Speed
• Torque (if known)
• DBSE (Distance Between Shaft Ends)
• Required Service Factor (if applicable)
• Quantity

• Driving Machine

• Driving Machine
  Please Select an optionMotorTurbineRecip EngineOther
• Shaft Type
  • Straight Shaft
  • Tapered Shaft
  • Flange
  • Other
• Straight Shaft Length
• Straight Shaft OD
• Tapered Shaft - OD
• Tapered Shaft - Length
• Tapered Shaft - Taper
• Tapered Shaft - Shaft nut info
• Flange - OD
• Flange - Bolt Circle
• Driving Machine - Other

• Driven Machine

• Driven Machine
  Please Select an optionCompressorPumpDynoFanOther
• Shaft Type
  • Straight Shaft
  • Tapered Shaft
  • Flange
  • Other
• Driven Machine - Other
• Straight Shaft - OD
• Straight Shaft - Length
• Tapered Shaft - OD
• Tapered Shaft - Length
• Tapered Shaft - Taper
• Tapered Shaft - Shaft nut info
• Flange - OD
• Flange - Bolt circle

• Other Information

• Limiting OD
• Other information specific to this application
• Subscribe To Our Mailing List
  • Yes
  • No
  Sign up for emails to get the inside scoop on everything Coupling Corporation of America. Be the first to know about new products, success stories and special events throughout the year.

Δ