OPTIONAL DELIVERY ADDRESS (Home or P.O. Box)
If you are entering an optional delivery address, denotes a required field in this address block.
A. My company is best described as: (check only one)
B. My primary job function is:
(if you selected "Other" please specify):
C. Do you intend to purchase a wide format printer in the next 6 months?
If the answer to C is "yes", please check all that apply:
E. The number of people employed at this location is:
F. Annual Sales Volume at this location:
G. How many digital wide format printers does your company have?
H. I received the following publications personally addressed to me by mail:
(Check all that apply)
Audit Verification (Required)
In lieu of a signature, we require a personal identifier. To verify that you submitted this application please select below your day of birth.
What is your day of birth?