This form is designed to assist Printers Plus Inc. in helping you choose a Printer or Data Capture solution appropriate to your needs. Upon receipt of the form, a Printers Plus representative will contact you.

Mandatory fields are marked with an asterix: *

Contact Information

 

Email address* :

 

Full Name* :

 

Telephone Number*:

 

Company Name:

 

Company Address (Street):

 

Company City:

 

Company State/Province*:

 

Zip Code:

 

Fax:

Product Details

 

Product of interest?
(Hold down Ctrl key to select more than one)

 

Interface:

 

Operating System:

 

Emulation Run:

 

Type of Printing:
(What types of jobs will you normally print?)

 

Duty Cycle:
(Approximately how may impressions per month will you print?)

 

What is your budget?

 

Options Required:
(Duplex Unit, Additional Input/Output, Power Stack, Internal Forms Overlay)

 

Date Required?

 

Please provide any other relevant details:

 

How would you like us to contact you*(select at least one)?

Email

Phone

Fax