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Literature / Price and Delivery Request Form Please fill in all fields below to receive information. If a field does not apply enter "none". Contact Information: Name: Mail Stop: Company: Address: City: State: Zip Code: Country: Phone: Fax: Email: I am interested in: Literature Pricing Please send me information about the following item(s). Enter Model number (if known), item description and quantity desired (e.g., 3.5 mm male to N female, Model 8023, Qty 3). Or to request Maury literature, enter the title or document id number. (e.g., to receive a copy of Maury's product data sheet for Model A034B precision 3.5mm connector gage kit, request data sheet number 2Y-020, or as an alternative, enter the title "Precision Connector Gage Kit APC3.5 and MPC3". How do you wish to receive the information? By Phone By Fax By Email How did you learn about Maury Microwave products? (Please check all applicable boxes.) Web Search Tradeshow Exhibit Referral Trade Publication Sales Rep If "Trade Publication" is checked, please specify: Magazine Ad New Product Update Feature Article Name of Publication: Microwave Journal RF Design Microwave & RF Microwave Product Digest Microwave & RF Product Directory Test And Measurement World Wireless Design and Development Applied Microwave & Wireless Month of Publication: January July February August March September April October May November June December If you heard of us in some other way, please specify:

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