E-mail Address: * Company Name * Name: * Who besides yourself will be involved in making this decision Address: * City: * State: * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, DC West Virginia Wisconsin Wyoming --Territories-- American Samoa Federated States of Micronesia Guam Midway Islands Puerto Rico U.S. Virgin Islands Zip: * Home Phone: Work Phone: * Fax Number: When is the best time to contact you? Morning Afternoon Evening What is the best way to contact you? Phone E-mail Fax Message: How many copy machines would you like to purchase or lease * 1 2 3 4+ Please describe what type of copies you need to produce * Black & White Both Color and Black & White Color Copies Only Not Sure What is your overall projected monthly copier volume * Not Sure Low (less than 3,000 copies) Medium (3,000 - 10,000 copies) High (10,000-30,000 copies) Very High (30,000+ copies) Would you like information on leasing options * Yes No What is your estimated budget for each copier purchase or lease? * $1000 - 2999 $3000 - 4999 $5000 - 9999 $10000 - 14999 $15000 - 19999 $20000 - 29999 $30000+ In addition to copying, what other functions would you like? * None Printing Scanning Faxing Emailing Document Imaging When would you like to purchase your copier(s) * ASAP In two weeks In one month Not Sure How would you classify your business or organizations * 1-5 employees 6-10 employees 11-20 employees 21-50 employees 50+ Federal/State/Local Government Manufacturer Commmercial Educational Residential What paper sizes or types do you need your copier machine to handle? * Letter (8.5 x 11) Legal (8.5 x 14) Ledger (11 x 17) Tabloid (17 x 22) Cover Stock Transparencies Blue Print Banner/ Large Format What make or model copier do you currently use? If you have a current copier is it leased or owned? Leased Owned If you have a current copier, who services your machine? If you currently have a copier, What type of maintenance agreement do you have? Do you have a copier you would like to trade in? Yes No * Required Email form by myContactForm.com