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RFSI QUOTE REQUEST

CUSTOMER INFORMATION

NAME: Company:

Street Address:

City:  State / Prov:    Zip:

Phone:  Ext:     Fax:

Email:            Mail Station:

Customer Business Information

Design      Manufacturer     Re-Sell

Customer Category Information

   Job Position:                                       Market:

Design Engineer                                  Military

Component Engineer                           Commercial

 Purchasing                                         Consumer

Customer Details:

PICONICS

High Rel Chip inductors 
               Qty:  Part No / Desc:

Chip Resistors   
               Qty:  Part No / Desc:

Chip Attenuators   
               Qty:  Part No / Desc:

 

Other   Qty:  Part No / Desc:

Catalogue

Sample                 Qty:  Part No / Desc:

Project Name:           Potential:

 

Comments:

 

 

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                           Last modified: July 20, 2005