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Customer Information:
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      Your Name*:
   Company Name: 
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Board Information

                Part #:-
           # of Layers: Min. Copper Wt. oz.
1.0
.5
1.5
2.0
3.0
4.0
Other

              Material:
FR-4
CEM-1
G-200
GeTek
Teflon
Other

                        Thickness oz.
.062"
.031"
.093"
.125"
.015"
Other

               SMT Top: # of Pads Pitch 
.050
.012
.015
.020
.025
Other
 
            SMT Bottom: # of Pads Pitch 
.050
.012
.015
.020
.025
Other
 
            Dimensions: X 
            # of Holes:Smallest Drill Size
                Legend:
Top
Bottom
None
Both

                 Color:
White
Yellow
None
other

  Smallest Trace/Space:
8 mil.
10 mil.
12 mil.
> 12 mil.
4 mil.
5 mil.
6 mil.
7 mil.


                       
8 mil.
10 mil.
12 mil.
> 12 mil.
4 mil.
5 mil.
6 mil.
7 mil.


                  Mask:
LPI
WET

                       
Both
Top
Bottom
None

                       
Green
Red
Black
None
other

      Testing Required:
Comparitive
Flip Flop
Holes Only
Netlist
None

Additional Circuit Information:

Please check all that apply:

Gold Fingers Routing Vscoring Slots Buried Vias Blind Vias

Delivery Information Comments

Quantity	# Working Days

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