Daven Industries, Inc.

Name:*
Company:*
Address:*	Street: City: State: Zip:
Phone Number:*
Fax Number:
E-mail Address:*

* required

1. Maximum material load:

2. Drive square size:

3. Standard drive shaft (1.24" diameter x 6" long):
     Yes    No

4. Modified drive shaft:
     Length   Diameter   Keyway

5. Web speed:

6. Foot mount style:    Yes    No

7. Flange mount:    Yes    No

8. Replacing existing Safety Chucks:  Yes   No
    if yes then:
    A. What brand
    B. Model number
    C. Existing bolt mounting holes necessary:  Yes   No

Button Style
Expanding Shafts

Leaf Style
Expanding Shafts

Lug Style
Expanding Shafts

External Strip
Lug Shaft

Differential
Controlled Slip Shaft

Medium/Heavy Duty
Safety Chuck

Light Duty
Safety Chuck

Bayonet
Drive Coupling