Request for Quotation


Contact Name & Position *
Company Name: *
Company Address: *
Email Address: *
Land Line Telephone Number: *
Do You Have a Drawing or Sketch *	Yes No
If / When Placing order - will drawing be available *	Yes No
Estimated Annual Quantity *
First Order Qty & Follow-on batches *
Target Purchase Price *
Flexible or Rigid *
Support Plate Required *	Yes No
If a support plate is required - please provide full details.
Membrane Size [mm x mm] *
Corners: Radius / Square *
Do you require holes: number / sizes *
Do you require cut-outs: number & sizes *
Tail Length *
Tail Location *
Graphic Layer *	Yes No
Number of Colours *
Graphic Layer Finish *
Embossing *	Yes No
Display Windows - Number *
Indoor / Outdoor *
Number of Keys / Switches *
Tactile or Non Tactile *
What type of switch circuit - Matrix? Common? *
Output tail track pitch? Our standard is 2.54 - suitable for Nicomatic crimp connector. *
Tail Connector *	Yes No
Embedded LED's - Number *
Any Special Requirements *