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  SIGNAL INTEGRITY SERVICES - SI Request Forms - Data Rate Cable Request Form
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Please fill out the information below. Fields marked with [ * ] are required. When you have completed the form, click the Submit Request Form button at the bottom of the page.

If you have any questions about our Data Rate Cable Request Form or on Samtec’s data rate cable capabilities, you can contact our Data Rate Cable Group or call them directly at 800-726-8329 (+812-944-6733).



Contact Information
First Name   *

Last Name

 *
Company   *

Title

 *
Address1   *

Address2

Address3 
City   *

State

Province 

Postal Code

 *
Country   * Phone  *
Email   * Fax

Application Information
Single-Ended or Differential
System Impedance  Ohms
Unit Length  inches
Insertion Loss (Attenuation)  -dB
Bandwidth/Frequency (Typical)  GHz
Bandwidth/Frequency Spec
Allowable Return Loss  -dB
NEXT  %
FEXT  %
Number of Signals
Prop Delay  Picoseconds
Skew  Picoseconds
Data Encoding  (Examples = Binary, PAM- 2, PAM-4)
Within the rack or rack-to-rack?
Number of Mating Cycles
Target Price  USDollars
Prototype Quantity
Prototype Quantity Start Date   mm//dd/yyyy
Production EAU
Production Start Date    mm/dd/yyyy
Description/Explanation of Application