| Name of contact: 
 | Name of company: 
 | 
                
                  | Reply e-mail address: 
 | Phone number: 
 | 
                
                  | Country: 
 | Project name or part number: 
 | 
                
                  | Service required: 
 | Desired turn time or completion date needed: 
 | 
                
                  | Type of design: 
 | Type of schematic being provided: 
 | 
                
                  | PCB footprints 
                    to be made by Greenmil PCB Design: 
 Common parts include:
 SMT R's, L's and C's
 SOIC's
 | Total number 
                    of components on PCB: 
 | 
                
                  | Special components or circuitry: (Use Ctrl key to multi-select items)
 
 | Special routing on PCB: (Use Ctrl key to multi-select items)
 
 | 
                
                  | Total special 
                    components count? (How many BGA's, etc...)
 
 | Total node 
                    count in netlist? (Pin to Pin connections)
 
 | 
                
                  | Test points for ICT (In Circuit Test) on all nodes of the PCB? 
 
 
 | Type of substrate: 
 | 
                
                  | PCB overall thickness: 
 | Number of 
                    layers: 
 | 
                
                  | Overall 
                    board dimensions: X 
 | Overall 
                    board dimensions: Y 
 | 
                
                  | Is a production panel drawing required? 
 
 
 | Does the PCB have to be designed in a 
                    specific software package? 
 
 
 
 | 
                
                  |  Brief description of design
                      
                      or additional requirements:
 
 
 
                      
                    
					   
                      
                     |