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OPLINK COMMUNICATIONS, INC. PRODUCT REQUEST FORM

Please fill out this form as throughly as possible. Information you provide will help us to expedite your request. If your brower does not support forms, please print out this page and fax it to (510) 933-7300.

Required fields are indicated by a red asterisk.

Name*
Title
Company*
Division
E-mail*
Phone*

Fax

Address*s
City* State Zip
Country*
   
ACCOUNT INFORMATION
We have an Account with Oplink : YES NO
ACCOUNT #
STANDARD CATALOG PARTS
(Please fill out this section if you would like a quote from our standard web or printed catalog product offering)
Part Number Description Qty
CUSTOM PRODUCT SPECIFICATION
TYPE OF REQUEST*
Purchase Info. Call Back Meeting Request
PROJECT TIMELINE
DeliveryTimeline : ASAP 1 month Ongoing
   Other
FULFILLMENT DESTINATION
If you know, please indicate an Oplink's office you would like to fulfill your order.
 

 
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