Warranty Registration

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Submitted by admin on Wed, 08/03/2011 - 09:22

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First Name: *

Last Name: *

Company: *

Address: *

City: *

State/Province: *

Zip/Country Code: *

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E-mail: *

Phone: *

Model: *

Serial Number: *

Date Installed: *

Did an Astro-Med Field Service Technician install your product:

Yes

Did the product run properly upon installation:

Yes

Are you completely satisfied with this product:

Yes

If no, please describe how you would improve it:

Please describe your involvement with your Astro-Med product:

I use/will use Astro-Med products

I recommend the purchase of Astro-Med products

Both

Neither

Which of the following best describes your job function:

General/Corporate Management

Field Service

Education

Electrical Maintenance

Evaluation/Quality Control

Manufacturing/Production

Purchasing/Procurement

Research

R&D Engineering

Test Engineering

What is the primary industry of your company:

Aerospace

Automotive

Education

Electronics

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Heavy Equipment

Industrial Automation

Manufacturing

Medical

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Pulp/Paper

Service

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Other

For what application(s) will you use your Astro-Med instrument:

Is this a new requirement or are you replacing an existing system:

New requirement

Replacing existing system

Do you plan to review data collected with your Astro-Med system with a PC:

Yes

If yes, what software do you plan to use? (check all that apply):

Excel

FlexPro

MATLAB

Mathcad

LAbVIEW

DADiSP

Other

Where did you hear about us? (check all that apply):

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