Request for Layout Quote
	Internal Use Only   Quote#: ______

Company:		Date:
Name:		Title:
Address:
Email:
Phone:		Fax:

Board Title:

Part Number/Rev.:

Board size:	Multi-pak: Yes    No
If yes, how many in pak:
# of Layers:	# of Components (est.):	# of Pins (est.):
Minimum Trace/Space:
Via technology: Thru Hole    Blind    Buried    All
Minimum via hole diameter:
Special routing requirements: Diff pairs    Length Balancing    Special Trace Widths
Special routing requirements must be supplied in the net list or in a text file.
Placement: Single    Double Sided
Technology: Thru Hole    SMT    Mixed
Is test required after assembly: Yes    No
If yes, what type of test: Functional    Fixture
If fixture, will it be a single or double sided test fixture: Single    Double
Supply a preliminary copy of Mechanical, BOM, and schematic if possible.
Accelerated schedule: Yes    No

Comments:

Submit this request via email or print out and fax it to (503) 640-6437.