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  SIGNAL INTEGRITY SERVICES - SI Request Forms - Signal Integrity Services 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 prefer, you can open a PDF version of this Request Form that you can print off, complete, and fax back to us at 717/697-8872.

If you have any questions about our SI Request Form or on Samtec’s SI capabilities, you can contact our Signal Integrity 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
PCB Area available for Connector  inches X inches
Pin Centerline Required  inches
Mated Height   inches
Number of mating cycles
# of I/Os
Single-Ended or Differential
Signal-to-Ground Ratio
System Impedance   Ohms
Signal Rise Time (Typical)   Picoseconds
Signal Rise Time Spec
Bandwidth/Frequency (Typical)   GHz
Bandwidth/Frequency Spec
Allowable Insertion Loss %
NEXT %
FEXT %
Propagation Delay Picoseconds
Skew Picoseconds
Data Encoding   (Examples = Binary, PAM- 2, PAM-4)
Signal Technology
(Examples = LVTTL, SSTL-2, Rambus, GTL+, LVDS, PECL, LVPECL, CML)
Termination Type (Examples = One End Parallel, Both Ends Parallel, Series, Active, RC)
Clocking/Data Recovery
(Examples = Synchronous, Asynchronous, SourceSynchronous, CDR)
Topology
(Examples = Point-to-Point, Multi-Drop, Point-to-Many-Point,Star,T)
Drivers
(Examples = Single, Multiple Bi-Directions, Simultaneous Bi-Directional)
Target Price  US Dollars
Prototype Quantity
Prototype Quantity Start Date    mm/dd/yyyy
Production EAU
Production Start Date    mm/dd/yyyy
Description/Explanation of Application



 
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