Name:
Phone:
Company:
Fax:
E-Mail:
Street Address:
City, State, Zip: ,

Part Number: Revision
Board Type: # of Layers: PCB Size: X
Cut-Outs / Notches: Please Specify:
Critical Dielectrics:
Base Material: If Other:
PCB Finished Thickness:
Finished Copper Thickness: Externaloz /Internaloz
Hole Count:Total Number Of SizesSmallest Hole Size
Minimum Line Width & Spacing /
Surface Mount: Sides:
Finish Type: If Other:
Soldermask: Sides:COLOR (If other than green):
Letterscreen: Sides:COLOR (If other than white):
Gold Tabs: Number of tabs:
Electrical Test:
Quantity Required: *Multiple RFQ inquiries use "COMMENT" Form.*
Delivery Required: If Other:
Salesperson:
Comments:
* Pricing and delivery contingent on base material availability, special services required, and review of finalized design files.
New order entry checklist
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