* Indicates Required Field
First Name
*
:
Last Name
*
:
Title
*
:
Miss
Mrs.
Mr.
Job Title
*
:
Company Name
*
:
Address
*
:
e.g. RM1307, Anhui Buiding, No.3094 Mingzhu Nan RD, 519020
Location
*
:
e.g. Macau, Hong Kong, USA, UK
Work Phone
*
:
e.g. +86-756-6138391
Mobile Phone :
e.g. +86-137-000-0000
Fax Number
*
:
e.g. +86-756-6138392
E-mail
*
:
e.g. support@smtbox.com, E-mail will never be published
Website URL :
e.g. www.smtbox.com
Equipment Brand
*
:
e.g. SIEMENS, SIPLACE
Equiment Model
*
:
e.g. CP6, CP7, CM402, CM602
Part Number
*
:
e.g. 00310087-52
Part Name
*
:
e.g. power feeder, SMD nozzle assy
Quantity
*
:
e.g. 100 UNIT, PC(s), EA or SET
Description
*
:
Please describe your requirement in the box above.