Atmel Products - Sample Request

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Sample Request Instructions/Guidelines
Be sure to fill in all fields completely. If you do not wish to have any alternate speeds or packages, put "no alternatives" on the box where it asks for alternative speed and package on the request. (Note: if you do not fill that out, we will automatically upgrade to a higher speed or different temperature). Please refer to your local Sales Representative for maximum sample order quantities. Allow 72 hours for processing and shipping. If products requested are not currently available in sample stock your Representative will let you know the shipping schedule. Orders are shipped Federal Express (2 Day) to your local rep every Tuesday or Thursday. If you require faster shipment Atmel can charge your shipping carrier (Example: Fed Ex, UPS, or Airborne) account directly. You MUST include a shipping account number and carrier name. Atmel will not "rush ship" without this information. Fields marked with an asterisk (*) are required.
First Name*
Last Name*
Job Title*
Job Function*
Company*
Address 1*
Address 2
City*
State/Province* (US and Canada only)
Region* (only if outside US and Canada)
Postal Code*
Country*
Telephone*
Email*
Fax
Products Requested	Part Number*	Quantity*	Alternative Speed or Package*



Application	Telcom	Consumer/Automotive
	Computer	Industrial/Military
	Network	Other
Potential Production Quantity	Near Term*	Long Term*
First Buy Date*
Parts per Board*
Urgent Sample Shipping	Carrier Name
Urgent Sample Shipping	Priority Account
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