Fill in the fields with as much information known as possible, and press the submit button at the end of this form to mail it to the sales department. If this is a rush delivery, contact the sales department at (973)284-1600.

CONTACT NAME:
COMPANY:
ADDRESS:
CITY:		STATE:		ZIP:
PHONE:		FAX:
SEND QUOTE VIA:	FAX E-Mail Voice
E-MAIL ADDRESS:

PART INFORMATION:
PART #:
REV:
QTY:
LAYER COUNT:
SPECIFICATION:	Custom UL IPC600 Class? Class I Class II Class III
DIMENSIONS:	in. X in.
PLATE THROUGH HOLES:	Yes No
MIN LINE WIDTH:	mils.
SPACE:	mils.
SCORE OR ROUTE ARRAY:	Yes No
ARRAY SIZE:	X
FINISHED COPPER:	oz.
MATERIAL THICKNESS:	.062" .031" .093" .125" .150" .200" .225" .250" .008" .015" <thickness not listed>
FINISH	LEADED SOLDER Rohs - OSP Rohs - TIN Rohs - Lead Free Solder Rohs - ENIG Rohs - Silver
MATERIAL TYPE:	FR-4 FR-5 G-200 GeTek Polyimide Teflon
NUBMER # OF HOLES:
SMALLEST DRILL SIZE:
NUMBER OF SLOTS:
NUMBER OF MASK SIDES:	One Both None
NUMBER OF LEGENDS:	One Both None
NUMBER OF GOLD EDGES:	1 2
NUMBER OF GOLD FINGERS:
GOLD THICKNESS:	None 30-50 MICROINCHES 50-75 MICROINCHES
ELECTRIC TEST:	Yes No
NUMBER OF SMT SIDES:	One Both None
SMALLEST SMT PITCH:
# OF SMT PADS:
LEAD TIME:	Standard-3 weeks All-Quick Turn plus Standard 24 Hours 2 Days 3 Days 1 week 2 week 3 week

OTHER REQUIREMENTS:
Attachment: