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name (required):
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company:
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address (required):
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city:
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state/province:
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zip:
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country:
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telephone (required):
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fax:
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e-mail (required):
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website:
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type of business:
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independent studio in-house studio location scientific/engineering pre-press facility educational institute other (please specify): |
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camera body type
(i.e. Cambo, Mamiya, etc.): |
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computer type
(i.e. Macintosh G3): |
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other equipment used:
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equipment purchased:
(required) Please fill out form once for each piece of equipment being registered. |
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serial number:
(found on bottom of camera back or BatPac™) |
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| dealer / sales representative: (required) |
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purchase date:
(required) |
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extended limited factory
warranty purchased: |
no yes for years |
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