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BUDGETARY CONNECTOR QUOTE REQUEST FORM 

Name:	
Company:	
Address:	
Address:	
City:	
State:	
Zip:	
Phone:	
Fax:	
e-mail:	

Please provide specifications for the connector type you require:
T-Type
T-Type Connector

  Length:
Height:
Width:
Pitch:

Quantity (25K pcs min.):
Your Part Number:
TS-Type
 TS-Type Connector

  Length:
Height:
Width:
Width1:
Pitch:

Quantity (25K pcs min.):
Your Part Number:
TG-Type
TG-Type Connector

  Length:
Height:
Width:
Width1:
Pitch:

Quantity (25K pcs min.):
Your Part Number:

TB-Type
TB-Type

  
Length:
Height:
Width:
Pitch:

Quantity (25K pcs min.):
Your Part Number:

IR-Type
IR-Type

  
Length:
Height:
Width:

Tape (Adhesive or Mylar):
Quantity (25K pcs min.):
Your Part Number: 

Please provide a brief description of your application:

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