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Q2 Customer Application/On Line Catalog Registration
Q2 Customer Application/On Line Catalog Registration
We take your privacy seriously and are only asking for information to better understand your business and service your account
Company Name
*
DBA
Bill to Street Address
*
City / State/ Zip
*
Country
*
Ship to Street Address
City / State / Zip
Phone Number
*
Fax
Website address
General Email
Your Name
*
Your Title
*
Your Email
*
For Profit Service
*
Yes
No
Date Business
Commenced
How did you hear about Q2?
Machine Lines Serviced
OEM Authorized?
Copiers
Printers
Fax
MFPs
1.
YES
No
Yes
No
Yes
No
Yes
No
Yes
No
2.
YES
No
Yes
No
Yes
No
Yes
No
Yes
No
3.
YES
No
Yes
No
Yes
No
Yes
No
Yes
No
4.
YES
No
Yes
No
Yes
No
Yes
No
Yes
No
5.
YES
No
Yes
No
Yes
No
Yes
No
Yes
No
# of Service Techs
Officers of Company
Title
1.
2.
3.
Service Manager
Parts Manager
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