Sign, RIP, Print & Cut Software 'Beta Tester' Application Form

Note: Please leave blank any fields unrelated to your business

Please provide the following contact information
Customer Number
Title	- Please Select - Mr. Mrs. Ms. Miss
Contact
Business Name
Street Address
Suburb/Town/City
State/Province
Zip/Post Code
Country	AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOWINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA (local name: Hrvatska) CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRANCE, METROPOLITAN FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA Gaza Strip HAITI HEARD AND MC DONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAU MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEUTRAL ZONE NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT KITTS AND NEVIS SAINT LUCIA SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA (Slovak Republic) SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA ST. HELENA ST. PIERRE AND MIQUELON SUDAN SURINAME SVALBARD AND JAN MAYEN ISLANDS SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM VIRGIN ISLANDS (BRITISH) VIRGIN ISLANDS (U.S.) WALLIS AND FUTUNA ISLANDS WESTERN SAHARA YEMEN YUGOSLAVIA ZAIRE ZAMBIA ZIMBABWE
Work Phone
Home Phone
FAX
E-Mail
URL

Please provide the following information about your Main Large Format Printer

Printer Make	- Printer Make - Canon ColorSpan DGI Encad/Kodak/Océ Epson Gerber Graphtec Hewlett Packard Mimaki Mutoh NUR Roland Summagraphics Vutek Zund-Wild ....... Accu Plot Hermes Lexmark OYO Selex Signware Xerox ZBE
Model
Ink Channels	- Ink Set - 4 Color CMYK 6 Color CMYK Lc Lm 6 Color CMYK Or Gr 8 Color CMYK Lc Lm Or Gr 8 Color CMYK Or Gr Rd Bl Other Unsure
Type	- Printer Type - Ink Jet Electrostatic Laser Organic Solvent Thermal Unsure
Max Width (in)
Variable Dot	- Select - No Yes Unsure
Window's Driver	Yes No Unsure - Select -

Please provide the following information about your second Large Format Printer

Printer Make	- Printer Make - Canon ColorSpan DGI Encad/Kodak/Océ Epson Gerber Graphtec Hewlett Packard Mimaki Mutoh NUR Roland Summagraphics Vutek Zund-Wild ....... Accu Plot Hermes Lexmark OYO Selex Signware Xerox ZBE
Model
Ink Channels	- Ink Set - 4 Color CMYK 6 Color CMYK Lc Lm 6 Color CMYK Or Gr 8 Color CMYK Lc Lm Or Gr 8 Color CMYK Or Gr Rd Bl Other Unsure
Type	- Printer Type - Ink Jet Electrostatic Laser Organic Solvent Thermal Unsure
Max Width (in)
Variable Dot	- Select - No Yes Unsure
Window's Driver	Yes No Unsure - Select -

Please provide the following information about your Main Plotter  

Plotter Make	- Plotter Make - Allen Datagraph Anagraph Aristomat CSR DGI Encad Gerber Graphtec GRC Houston Instruments Ioline Kodak Lynx Mimaki Mutoh Newstar Omega Roland DG Summagraphics VE Ultra Zeta Unsure Other
Model
Emulation	- Select - HPGL GPGL DMPL CSR Gerber Proprietary Mimaki Proprietary Roland Proprietary Unsure Other
Type	- Plotter Type - Trailing Blade Swivel Blade Thermal Other Unsure
Max Width (in)
Window's Driver	- Select - Yes No Unsure

Please provide the following information about your Current RIP Software

Brand
Version #
Year of Purchase:	- Select - Before 1995 1996 1997 1998 1999 2000 2001 2002 Unsure
Dongle/Block	- Select - Yes No Unsure

Please provide the following information about your Current Sign Software

Brand
Version #
Year of Purchase:	- Select - Before 1995 1996 1997 1998 1999 2000 2001 2002 Unsure
Dongle/Block	- Select - Yes No Unsure

How would you rate your opinion of your Current Sign/RIP Software

bad poor average fair good