Contact Name

Company Name

Address

Phone

FAX

Email

Date

Part Number

Revision

Quantity

Quantity Per Release

Date Due

Type of Tooling Supplied

  Film   Disc

Photo Plotting Required

  YES   NO

Material Type

Thickness

Line Width & Spacing

Number of Holes

Number of Layers

Number of Hole Sizes

Finished Piece Size

# Plated Through Holes

  YES    NO

Following applies to conventional boards only

Supplied in Multiple Image Panel Form

  YES    NO

Multiple Panel Size

Images Per Panel

Surface Mount

  YES    NO

Scored

  YES    NO

Routed

  YES    NO

Tested

  YES    NO

Plating

Solder Mask Over Bare Copper

  YES    NO

Gold

  YES    NO

Gold Fingers

  YES    NO

Number of Fingers

Solder Mask

Photoimageable

Screenable

Dry Film

Number of Sides

Color

Legend Screening

Color

Number of Sides

Special Instructions