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Customer Feedback
What Make/Model Machine are you looking to upgrade?
Do you currently own or lease it?
Own
Lease
N/A (You do not currently have a machine)
What type of machine are you interested in?
Multifunction Machine (COPY/PRINT/SCAN/FAX)
Black and White Copier
Color Copier
Fax Machine
Black and White Laser Printer
Color Laser Printer
Other
How many machines are you looking for?
One
Two
Three or More
If three or more, please note exact quantity:
What speed of machine are you looking for?
15 to 20 pages per minute
21 to 30 pages per minute
31 to 45 pages per minute
46+ pages per minute
What is your projected monthly volume?
Low Volume (Less than 3,000 copies per month)
Medium Volume (3,000 - 10,000 copies per month)
High Volume (10,000 - 30,000 copies per month)
Very High Volume (30,000+ copies per month)
Not Sure
What paper sizes do you require? (please check all that apply)
8 1/2 by 11 (letter)
8 1/2 by 14 (legal)
11 by 17
(tabloid)
All of the above sizes
Do you use heavy paper weights?
Yes
No
What multifunctional product functions needs do you require?
Color
Printing
Scanning
Faxing
E-mailing
Document Storage and Retrieval
No additional functions, we will just be making copies
Not Sure
Would you like information on a Maintenance Agreement?
Yes
No
When would you require delivery?
ASAP
In Two Weeks
In One Month
Other
If other, please specify a time:
What purchase option do you require?
36 month lease
48 month lease
60 month lease
Credit Card
Outright Purchase
On Account
Is there any additional information you would like us to know:
Contact Information
Company Name:
* Name:
* Email:
* Telephone:
Verification Image:
Enter Verification Image:
(only 6 lower-case letters)
