image


Galaxy Circuits, Inc. 'Request for Quote' Form * Expanded *
Use this form to Request a Custom Production Quote.

Please be sure to accurately complete all feilds


 
Name:

Company:

Phone:

Fax:

E-Mail:

Confirm E-Mail:

Address:

City:

State/Zip:
  
Attention :

P.O./ Reference #:


Delivery Information :
Specifications :

Dimensional Specs (in inches unless otherwise specified) :

Length  X Width
Length  X Width

External   Internal
Technology :
Primary   Secondary
SMT   BGA
Primary   Secondary
Material (starting copper) :


describe if 'other'
Holes - Per PCB :


Quantity   Size   Layers
 
?
Quantity   Size   Layers  
Solder Mask :

describe "other" color


Silk Screen :

describe "other" color
Surface Finish :
describe "other" finish

edges
Electrical Testing :


Special Requirements / Project Files / Description :







Optional Description or Comments :


Attach Your Project Files :
(
ODB++, Gerber 274-X, DXF, Excellon, Gerber,
Sieb & Meier, and Barco file types accepted)


 



image image image image image