Date: Respond By: Name: Title: Company: E-mail: Must enter e-mail* Phone: Fax: Mailing Address: (optional) Please indicate the quantities and maximum delivery time in days that you would like quoted. Quantity Delivery Board #: ___Board Size: X inches Material: _ ___Thickness: Number of Layers: _ _______ Type: Mixed SMT Thru-Hole Number of Holes: . Number of Sizes: Min / Max: . Copper: Ounce:___ Outer Layers: Inner Layers: Lines / Spaces: ____Gold Fingers X inches Soldermask: 1 2 _Type LPI OTHER Specify Other SMOBC Silk-screen: 1 2 Color WHITE OTHER Specify Other Finish: Routed Scored Routed and Scored Notches or Cutouts: Check the appropriate boxes that you want included: IPC Standards UL Logo Mil-P-55110 Controlled Impedance: Ohms __ _ Tolerance % E-Test yes no Netlist Golden Board Flip Clamshell Flying Probe SMT PADS: Top Quantity Bottom Quantity Which of the following will you supply? Gerber files Drill Files .DXF Files Artwork Additional Specifications, Comments, or Questions: Submit your request for a quote: Please print your filled out form for your records.