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High Temperature Electronic Module Quote Form
Contact Information (* = Required Information)

*E-Mail:
*Name:
*Company:
*Telephone:
Fax:

Technical Specifications (* = Required Information)

*Product Description
Customer's Development Phase New Design (Schematic Defined)
Product Prototyping
Redesign of Existing Product
Outsource or Second Source
*Packaging Need Build to Print
Required Packaging Engineering
Other:  
*Operating Temperature Range -20C to +85C
-55C to +125C
-55C to +200C
Other:  
*Package Requirement
Foot Print:
# I/O:
Hermeticity: Hermetic
Non-Hermetic
Type: Metal Package
Ceramic Package
Other Package:  
*Technologies
Substrate: Thick-Film
Thin-Film
Other Substrate:  
Assembly Process: Hybrid Chip & Wire
CSP (Flip Chip/BGA)
SMT for Microelectronics
*Screening Requirement(s): Element Evaluation
Component Tracability
Visual Inspection
Die Shear Test
Wirebond Pull Test
Packaging Leak Test
PIND
Temperature Cycling
Constant Acceleration
Shock
Vibration
Burn-In
Other:  
*Electrical Test Requirement In Process Electrical Test
Final Electrical Test
Other Electrical Test:  
Quality Standard Requirement
*Quantity to Quote:
Lead Time:
Annual Usage Forecast:
Customer Supplied Items
Other Requirements: