样品申请

样品申请表

感谢您光临美浦森半导体，我们将竭诚为您服务，申请样品请填写相关信息。样品我们会在3天内发出，如果是紧急需求请注明我们会第一时间安排发出，周日不安排样品，顺延到下周一安排。谢谢！

申请人 Applicant *

职务 Position *

客户名称 End Customer Name *

客户类型 Customer Type *

方案商 Solution provider

板厂 Board factory

成品厂 Finished product factory

贸易商 Traders

是否已报备 Has it been reported? *

是 yes 否 no

样品型号 Sample P/N *

样品数量 Number of Samples/pcs *

产品实际工作电信号输入 Actual working electrical signal input of the product

是否需要定制封装 Do you need to customize the icon? *

是 yes 否 no

封装类型或者脚位信息是否能改变 Can the packaging type or pin information be changed? *

是 yes 否 no

月用量 Monthly dosage/kpcs *

应用产品/项目 Application products/Project *

拓扑结构 Topology (选填 Don't fill in if you don't know)

驱动IC型号 Driver IC model (选填 Don't fill in if you don't know)

每板几路 How many routes per board (选填 Don't fill in if you don't know)

竞品 Competition *

新项目选型 New Project Selection 竞品替代 Competitor substitution

收件方式 Receiving Method *

自取 Take it yourself 快递 Express delivery

备注（用途/特殊需求/特殊外设）Remarks (purpose / special needs / special peripherals)