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    Customer Information

    Company Name*

    Address*

    City*

    Country*

    Province/ State*

    Contact Name*

    Email*

    Telephone*

    Fax

    General Information

    Part Number

    Rev Level

    Quantity Required

    Build Ship Qty

    EAU

    Delivery Required
    5 Days7 Days10 DaysStandard

    Specifications

    Board Size
    x cminch

    Assembly Panel Size
    x cminch

    Fabrication
    ScoreRouteCombination

    Material Type
    Standard FR4GFGHigh Td RoHSPolyimideOther

    If Other, Please Specify

    Material Thickness
    0.0620.0930.125Other

    If Other, Please Specify

    Number of Layers

    Min. Lin Width
    Inner: Outer:

    Min. Spacing
    Inner: Outer:

    Board Finish

    If Other, Please Specify

    Solder Mask
    LPIDry Film
    Colour

    Surface Mount
    NoneOne SideTwo SidesBGA

    Smallest Pitch

    Base Copper

    Outer Layer
    1/2 oz1 oz2 oz3 ozOther

    Inner Layer
    1/2 oz1 oz2 oz3 ozOther

    If Other, Please Specify

    Gold

    Tips
    Area Covered Min. Thickness

    Drill Holes
    Quantity: Smallest Size: Smallest Size Qty:

    Other Process Required:

    Buried Via
    Blind Via Via Layers to
    Peelable MaskCarbon InkControlled Impedence

    Describe Impedence Layers:

    Fabrication Specifications

    If Other, Please Specify

    Attach Gerber Data:
    Must be ZIP file of 10 MB or less.
    (Attach file prior to submitting form.)