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Lead Registration
Your Name
*
Referred by Company Name
*
AS Reader
CEG Kyocera Communications Equipment Group
KDA Kyocera Document Solutions America
SouthernCarlson
KII Display
Seiko
Customer's Name
*
Customer's Phone Number
*
Customer's Email
*
Customer's Company Name
*
Project Title
*
Customer Need By Date
*
Device Interest
*
Bar Code Scanning Solution
Dura Extreme+ "Unlocked"
DuraSlate Wi-Fi Tablet
DuraSport "Unlocked"
Seiko Printer
Multi-bay Device Charging System
PTT Solution/ PTT Accessories
Vehicle Mounting Solution
Other (Please specify in the notes below)
Project Quantity (Number of over all units needed)
1-9
10-50
51-500
500+
Customer Requested Trial
Notes
Form Type
Solutions Lead Entry
Submit