DELIVERING THE FUTURE.
CONNECTING THE WORLD.

Technology leaders around the globe rely on JST connectors to bring their innovations to life.

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ROHS/REACH/CMRT Request Form

Requester Information

You are a:*
- Customer
- Distributor
- Representative
- Employee

Name*

Title

Company

Phone Number*

We use your phone number to contact you about actions we need you to take to ensure the security of your account, changes to our Terms & Conditions and Privacy Policy, and to ask for feedback. We will never share your phone number with 3rd party companies.

Email*

We use your email address to contact you about actions we need you to take to ensure the security of your account, changes to our Terms & Conditions and Privacy Policy, and to ask for feedback. We will never share your email address with 3rd party companies.

Email 2 (optional)

Address Line 1*

We use your address to contact you about actions we need you to take to ensure the security of your account, changes to our Terms & Conditions and Privacy Policy, and to ask for feedback. We will never share your address with 3rd party companies.

Address Line 2

Country*

State/Territory

City*

Zip Code

End Customer Information

To expedite your request, we need to know from whom you purchased the products listed below.

Company Name*

Contact Name

Contact Email*

Contact Phone Number*

Application*

Estimated Annual Usage*

Purchased From

Select the documents required:*
- RoHS
- REACH
- CMRT
- Other (Please describe below)
Part Number
*
- I have read and accept the Privacy Policy*
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LEAVE THE
ASSEMBLY TO US

The Guntersville Assembly Manufacturing (GAM) division of JST is a full-service
cable and harness assembly operation. By using the latest
technology and exclusive equipment, we are able to create cutting-edge
custom cable assemblies out of JST connectors.