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| (Note: Fields marked * are required entries.) |
| Customer Information |
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Company |
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*Name |
* |
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*Email |
* |
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Address |
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City |
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State |
ZIP |
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*Phone |
* |
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Fax |
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| Board Information |
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Order Type |
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Part Number |
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Revision |
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| Dimensions |
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Length |
(inches) |
Width |
(inches) |
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PCB Thickness |
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Layers |
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Other Thickness Specify |
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Other Layers Specify |
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| Holes |
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Total quantity of Holes |
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number of different hole Sizes |
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Smallest hole size |
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# Vias |
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| Copper (finished) |
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Inner (final) |
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Outer (final) |
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Board Material |
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| Line and Space |
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Minimum Line Width |
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Minimum Space (gap) |
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If Other |
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If Other |
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| Number of Silk Screen ("Legend") sides: |
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Silk Color |
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Solder Mask Type: |
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Mask Color: |
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Plug Vias |
Carbon Ink |
| Surface Mount Pads |
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Top Side |
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Pitch |
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Bottom Side |
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Other Pitch |
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| Finish Plating |
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HASL (Hot Air Solder Level) |
HASL Lead Free |
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ENIG (Electroless Nickle/Immersion Gold) |
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Gold (Electrolytic/Electroplated) |
Immersion Silver |
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Nickle |
White Tin |
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Gold Edge Connector ("Tabs"/"Fingers") on # Edges 1 2 3 4 |
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Total Linear In. |
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Total Thickness Micro In. |
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Selective Plating |
Full Body Plating |
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Hard |
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Hard |
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Soft |
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Soft |
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Thickness in Micro In. |
Thickness in Micro In. |
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Please provide detailed area on a separate sheet. |
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| Special Processing |
| Score/V-Groove |
"Jump" score |
# of Score Lines: |
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Edge Rout ("Milling") |
Counter Bore or Counter Sink |
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Blind or Buried Vias |
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| Impedance Controlled |
+- 5% |
+- 10% |
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| Board Layout |
| Individual PCB |
Panel (adjoined/array/pallet) |
Set of multiple P/N |
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Array/Set # UP |
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Dimensions |
x (inches) |
| Electrical Testing |
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No Test |
NET-LIST |
Comparison |
| Quanity & Delivery |
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Qty Required |
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*Delivery Request |
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Qty Required |
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Delivery Request |
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Qty Required |
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Delivery Request |
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Qty Required |
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Delivery Request |
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Qty Required |
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Delivery Request |
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| Purchase Order |
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PO # |
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| Data File |
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File Name(s) |
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Will Send By |
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| Comments / Special Instructions |
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