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Use the following form to place a consigned assembly rfq. Our online processing system will process your submitted form and send it to one of our courteous staff members, who will be in contact with you shortly. Please Complete the Following Form for a Consigned Assembly RFQ Company: Your Name: Title: Phone (999) 999-9999: Fax (999) 999-9999: Email Address: Bid for Award: Yes Bid for Proposal: Yes Part Num / Rev: / Layer Count: Board Size (w x h): x Legend: 1 Side 2 Sides Gold Plated: Yes No Copper Plated: Yes No Surface Mount: 1 Side 2 Sides Thru Holes: 1 Side 2 Sides Solder Type: No-Clean RMA Hi-Temp Test Required? Yes No Bom Enclosed (e-mail)? Yes No Print Enclosed (e-mail)? Yes No Delivery Requirements: One Week or Less Two Weeks or Less Three+ Weeks Other:   Comments: