| *Required Fields
|
| Enter your
Imaging Path Sales Representative |
If you are unsure - Enter
"Unsure" |
| *Company |
|
| *First Name |
|
| *Last Name |
|
| Title |
|
| *Phone Number |
() |
| *Email Address |
|
| *Address |
|
| *City |
|
| *State |
|
| *Postal Code |
|
| Fax Number
|
() |
| Web Site Address
|
|
Current
Network Administrator is
Onsite or Third Party
|
|
Network
Administrator Contact Info
Name, Phone and Cell#, If
3rd Party- Company Name & City |
|
Server
Operating System
Choose all that apply
|
|
Client
Operating Systems
Choose any that apply
|
|
Printing
Enviroments
Choose any that apply
|
|
| Do you print
from any DOS based programs |
Yes
No |
If Using
TCP/IP, what IP address do you want assigned to the
device
example
- IP=192.168.1.20 Subnet=255.255.255.0
Gateway=192.168.1.1 |
|
| Is there a
Network Connection Installed at location desired for
Copier/Printer |
Yes
No |
| If No, When
will Network Connection be installed? |
MM/DD/YY |
Network
Wiring / Media in use.
Choose all that apply
|
|
| How many
workstations will need print capabilities |
|
List of
Softwares to print from and Software Version
eg. Photoshop
v7, MS Office XP, Autocad 2006 |
|
| Do you
require support for Adobe Postscript Printing |
Yes
No |
| What type of
scanning is needed? |
|
| If Scan to
Email is required, we will need the SMTP mail server
address: |
eg. mail.charter.net or
mail.wwt.net |
|
I accept Terms and Conditions |
| |
