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Advanced Package Rework

APR Qualification Registration Form

For printable version, please download here

Step 1: Representative Information

* Name:
* Firm:
* Telephone:
* Email:

Step 2: Distributor Information (if involved)

Is an End User Approved, Distributor involved?

Step 3: Customer Information

*Company:
*Contact:
*Address:
*City:
*State:
*Zip:
*Country:
*Telephone:
Fax:
*E-mail:

Step 4: Opportunity Information

*Part No.:
*Quantity:

Board Size:

x

Board Material:




*Component Type






Upload Image or PDF of the Component (file upload must be 5MB or less):


*Pitch Sizes:
*Solder Alloy:


*Flux Type:


*Existing Equipment:
*Expected Purchase Date:
*Expected Delivery Date:
*Approved Distributor:
*Purchase Window:



Step 5: Competitor Information

Competitor Name:
Competitor Part No.:
Competitor Price:
Competitor Website:

Step 6: Notes

Notes:

Contact Permission


We’d love to email you exclusive offers and the latest info from APR and associated partners. We’ll always treat your personal details with the utmost care and will never sell them to other companies for marketing purposes. You can unsubscribe at any time.

Follow this link for further information.

Please let us know if you would like us to contact you or not by selecting one of the options below.



Step 7: Submit