Custom Cable Order Form

Use this handy worksheet to select your custom built cable features
and fax back to us at .  We pledge to get to you with price,
part number, and delivery within 24hours !

CABLE TYPE: [ ]Unshielded  [ ]Foil and Copper Braided Shield  Other: _______________________
CABLE LENGTH: ________________ JACKET TYPE [  ]PVC [  ]Plenum
 

CONNECTOR A GENDER: MALE[ ] FEMALE[ ] CONNECTOR TYPE: (Circle One:) 1 DB9 2 DB15 3 DB25 4 DB37 5 DB50 6 15-Pin High Density 7 36-Pin Centronics 8 50-Pin Telco 9 RJ-11 4-Wire 10 RJ-11 6-Wire 11 RJ-45 8-Wire 12 DEC MMJ 13 M-50 14 M/34 (V.35) 15 50-Pin Berg 16 Spade Lugs, Lengths: 17 Other______________ SPECIAL INSTRUCTIONS (Circle Options:) 18 One End Cut 19 Pins Only 20 EMI/RFI (Plastic if not Specified) 21 Thumbscrews 22 Screwlocks:----Male----Female 23 90 Degree Hood ---Specify Cable Exit:__________ 24 Pairing 25 Flying Leads,Length:_________ 26 Label:_______________________ 27 Other------Please Attch Specs DRAIN WIRE(Circle One:) (Applies only to Foil Shielded Cables) 28 Cut Drain Wire 29 Pin Drain by Itself--------PIN#____ 30 Wrap Drain w/conductor-----PIN#____ 31 Attach Drain to Shell QUANITIY: ________________________ PART NUMBER: _____________________ PRICE: ___________________________ DELIVERY: _________________________ COMMENTS: _________________________ ________________________________ ________________________________

PINOUT Cntr.1          Cntr.2 Pin#  Connector  Pin# ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ---- ----      ----

CONNECTOR B   GENDER: MALE[ ] FEMALE [ ]   CONNECTOR TYPE:    (Circle One:)   1 DB9   2 DB15   3 DB25   4 DB37   5 DB50   6 15-Pin High Density   7 36-Pin Centronics   8 50-Pin Telco   9 RJ-11 4-Wire  10 RJ-11 6-Wire  11 RJ-45 8-Wire  12 DEC MMJ  13 M-50  14 M/34 (V.35)  15 50-Pin Berg  16 Spade Lugs, Lengths:  17 Other______________     SPECIAL INSTRUCTIONS   (Circle Options:)  18 One End Cut  19 Pins Only  20 EMI/RFI (Plastic if not   Specified)  21 Thumbscrews  22 Screwlocks:----Male----Female  23 90 Degree Hood--Specify Cable                  Exit:______________  24 Pairing  25 Flying Leads,     Length:____________  26       Label:_________________________  27 Other------Please Attch Specs  DRAIN WIRE  (Circle One:)   (Applies only to Foil Shielded    Cables)        28 Cut Drain Wire  29 Pin Drain by        Itself--------PIN#____ 30 Wrap Drain      w/conductor-----PIN#____  31 Attach Drain to Shell   COMPANY:      _________________________   NAME:   __________________________   TELEPHONE:     __________________________ FAX: _____________________________