Request for Information Form

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail

For product information please select all that apply:

vIDix™	Zebra Card Printers	CelériTime
IDimage™	Evolis Card Printers	Digital Cameras
IDvisitor™	Signature Capture	Fingerprint Scanners
IDaxxess™	SuperCard	ID Accessories
Fargo Card Printers

Other Information Requested or Comments:

Tell us about your ID badging applications:

Status	Applications User Reseller/VAR Systems Integrator None
Your industry
Number of badges needed
Current ID badge	Laminated PVC Instant Camera None
Project launch date