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Company Information:
(All *'s required)

   
*Contact:
   
Title:
   
Department:
   

*Company:

   

*Address:


           

*City:

*State: *Zip:
           
*Phone: Fax: *Email:
           
           

Imaging Device Information:

         
Copies Per Month: Prints Per Month:  
         
Fax Option?....................... Yes No Print Option?........ Yes No  
         
Scanning Option?............ Yes No Network Option? Yes No  
         
         

 

Mailing Device Information:
           
Current Postage Method: Current Brand:
         
Average Monthly Postage Cost: Current Model:
         

Rates Used (Please Check All That Apply):

First Class

Presort Periodicals Non-Profit      
Bulk Mail International UPS FedEx      
 

 

A better understanding of who our customers are helps us to offer you more individualized product
solutions and services. Please take a moment to answer the following questions about your business.
       
Business Type (i.e marketing, advertising, electrical,accounting, etc.)
       
Product Line or Industry:
       
Geographic Coverage: Business Style:
       
Group or Organization Affiliations? (Please list all below)
       
Number of Employees: Number of Locations:
       
Annual Sales?    
       
Who makes the purchasing decisions for your company?
Their Name:
       
Their Title:
       
Their Department:
       
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920 E. 21st Street, Des Moines, IA 50317
800-532-1565 Toll Free
515-262-2100 Des Moines IA
Des Moines   •   Coralville   •   Dubuque

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