Please fill out this form as completely as you can. Then print the form to pdf (or scan it) and email it to: paul_ruo@chupond.com
Please provide the following contact information:
Name Title Organization Street Address Address (cont.) City State/Province Zip/Postal Code Country Work Phone FAX E-mail URL
Please provide the name of the product about which you need more information. In the space below it, please provide a brief description of the type of information you need, for example: "send samples" or "send data sheet".
Product Name Information required
You may place a preliminary order/quotation for any part; simply enter the quantity desired and a description of the part or its part number. A confirmation with pricing for your particular part/quantity will be sent to you within 24 hours by e-mail:
QTY DESCRIPTION BILLING Purchase Order # Account Name SHIPPING Street Address Address (cont.) City State/Province Zip/Postal Code Country