Evaluation Kit Request Form

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Who We Serve
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About
Insights

Shipping Information

Street Address

City

State

Zip/Postal Code

Country

Fleet / Vehicle Information

Number of Vehicles for Evaluation

Vehicle Makes & Models

Model Years

Primary Vehicle Use Cases

J1939 CAN Bus Access Available?

Evaluation Kit Requested

Requested JakeLight Product(s)

Preferred Delivery Date

Technical Contact (if different)

Technical Contact Email

Objectives & Comments

Please describe your evaluation objectives, expected outcomes, or any special requirements

Acknowledgment

By submitting this form, you acknowledge that the JakeLight evaluation kit is provided solely for testing purposes and may be subject to additional terms and conditions.

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Contact

info@jakelight.org

© JakeLight LLC — “A Signal to Save Lives”
Patented Authorization Technology | Engineered for Integration Within FMVSS 108-Regulated Stop Lamp Systems |SAE J1939 Network Compatible

Company Information

Shipping Information

Fleet / Vehicle Information

Evaluation Kit Requested

Objectives & Comments

Acknowledgment