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Information Request

  Information Request Form

   To handle your request better, we need information about you and your business.

   Please supply us with the following information

     indicates required fields.

  First Name :
Middle Name :
  Last Name :
  Business Trade Name :
Business Legal Name :
if different than trade name
  Type of Business
(Please describe about your business)
Number of locations :
  Street Address :
(including building or suite number)
  City :
  State :
  Zip :
Country :
 Telephone :
Fax :
  Email Address :
Web Site Address :
  Which products or solutions are you interested in?
(Select one or more products)
Retail POS System
Restaurant POS System
Accounting/Financial System
Bar Coding System
E-Commerce/Web Development Solutions
Software Customization/Development
   if other,
  Request Information
(Select one or more requests)
Send me a brochure or demo cd.
A cagalog for all product line
Have someone call me
Would like to see a sales rep
   if other,
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