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Company Name 
Company Address 
 
City 
     State 
Your Name 
  Email Address 
Phone 
FAX 
Board Name
Board Num/Rev 
Component Count  Component Pins 
Board Length 
Board Width 
 Preferred 
48
Components 
Layer Count 
10 Other 
Slots/Notches 
Netlist Source 
 Routing Method 
Via Pad/Hole
(mils) 
60/3550/3040/24
32/1825/1120/8
Other 
Trace/Space
(mils) 
13/12 10/108/8 
6/6 4/4 3/3 
Other 
Desired Delivery 
Test Points/Pads 
Delivery subject to queue availability. Call for a firm date
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