Eval Board Request

Eval Board Request

The asterisk symbol "*" denotes a required field.

Part Information

* Semtech Part Number:

* Request Type (Select all that apply)

Quote Sample Eval Board

* Program EAU:

* Quote Quantity:

* Sample Quantity:

* Date Sample Needed:

* Quantity of EVB:

* Date Eval Board Needed:

Anticipated Prototype Date:

* Anticipated Production Date:

* Program Name:

Eval Board Specifications

(This information will help us customize an eval board that meets your needs)

Input Voltage (Nominal):

Output Current (Nominal):

Input Voltage (Min):

Output Current (Max):

Input Voltage (Max):

Operating Frequency:

Output Voltage:

Isolation:

Tolerance:

Efficiency Target %:

Output Voltage Ripple:

Application Information

* Market Sector:

Solution/Application:

* End Product:

Contact Information

* First Name:

* Last Name:

* Company:

Job Title:

* Address:

* City:

State/Province:

(For USA & Canadian Customers)

* Country:

Zip/Postal Code:

* E-mail:

* Phone:

Mobile Phone:

FAX:

Shipping Information

Same as Contact Information

* Address:

* City:

State/Province:

(For USA & Canadian Customers)

* Country:

Zip/Postal Code:

Comments

* Please type the number or characters you see: