PCB Assembly RFQ
Please provide current bill of materials via E-mail, fax or file upload for an accurate quote.
All pricing is budgetary until final data is received.

Customer Information:
Company:
Contact:
Phone:
Fax:
E-mail:
General Design Information:
Board Assembly Number:
Raw Board Number:
Schematic Number:
Customer Testing Spec Number:
Assembly Info:
Will you supply ALL Parts:  Yes:   No:
Quantity of boards to be assembled:
Request turn around Time:
PCA Test Requirements (check all that apply):
 In-circuit Test:   Functional  Test:   None: 
Other: 
Special Requirements:
Additional Comments or Special Requirements: