Network + Plus - Manufacturing to Customer Specifications

AV PRODUCTS NEW !!!

ACCESSORIES

PC / MAC INTERNAL

PC / MAC EXTERNAL

PERIPHERAL SHARE

DATA COMMUNICATION

IBM & SUN

RoHS INFORMATION

COMPANY :

COUNTRY :

FULL NAME :

OPERATION SYSTEM :

PHONE NUMBER :

PRODUCT APPLICATION:

EMAIL :

Where did you learn about this product ?

ADDRESS :

Is this your first Network Plus product(s) ?
Yes No

CITY :

Your primary business classification ?

STATE/PROVICE :

How did you hear about Network Plus ?

POSTAL CODE :

PART NO.	QTY	TARGET COST	COMMENTS

Sample Needed for Evaluation: No Yes
If Yes, Please complete the following...
Payment Terms
MC VISA AMEX Charge to Account (Network Plus Clients Only)
Card Number:

Expiration Date:

Billing Address: (if different from above)
Name:

Address:

**Note: You will be billed only at the end of your evaluation period, unless the product is returned or by special agreement.

For Customers Outside the United States & Canada
Shipping Methods: FEDEX UPS DHL Airborne Express
Shipping Account No.

Shipping Address:

Comments OEM/Custom Project Only: