ENQUIRY REFERENCE NUMBER
Date:


Customer Name:
E-mail Address:
Address:
Mfg. Location (Country):
Contact Person:
Application:
Product Marketplace:
Project Name:
Yearly Vol. Potential:
Project Duration:
Target$:

Physical Detail Requirements
*Outside Dimensions: W mm × H mm
*Thickness:    mm
*Viewing Area: W mm × H mm
*Active Area: W mm × H mm

Notes:

Display Format
Resolution W × H
Characters/Line: Dot Size W × H
Lines: Dot Pitch W × H
Font Size: Duty Cycle
Grey Scale
Estimate icon quantity:
Notes:

Module Structure     
Notes:

Interface Method     
Notes:

LCD Panel Details
View angle:
Mode:
Front Polarizer:
Notes:

Backlight Color LED Driver IC
Required module brightness level in cd/m2
Notes:

IC Details/Power input

Volt VOP= Volts
Notes:

Contrast Adjustment


Method

Notes:

Environmental requirements
Temperature Range: Operating: ~
Storage: ~
Any Requirements for wide temperature: ~
Humidity Levels: % Relative Humidity
EMI / ESD Requirements (attach any test requirements with Tooling PO):


Customer Approval Process:
Qty of Prototype units required:
Typical Prototype approval time:
Will Qual. Run be done before Production – what Quantity:
Typical Qualification / Approval Time:

Other customer Requirements:


OTHER PROGRAM NOTES OR COMMENTS:

Development Schedule:
Estimated (before tooling PO Placed)
Tooling PO Date:
Sample Delivery Date:
Sample Approval Date:
Spec Approval Date:
Qual. Order Date:
Production PO Date:
Date first Production PO must be delivered:
Notes:


Additional Program Comments (free form):