Executive Business Machines Inc - Winston-Salem NC

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Your Name
Company Name
Address 1
Address 2
City
State
Country
Zip Code
Telephone Number (Day)
Fax Number
E-mail Address (required for e-mail response)

All fields are optional

Your Name

Company Name

Address 1

Address 2

City

State

Country

Zip Code

Telephone Number (Day)

Fax Number

E-mail Address (required for e-mail response)

How would you prefer for EBMonline to contact you?	Email Phone Fax Regular Mail Onsite Sales Visit (Local Only)
What system are you currently using, if any?
Priority:	Best Value Lowest Price Highest Quality
You may indicate any budget restraints:	Undecided Less that $1000 Less that $2000 Less that $3000 Less that $4000 Less that $6000 Interested in Leasing Options Other
I prefer to have estimates for:	Purchase Lease Both Purchase and Lease
Choose the PRIMARY function of the system you need:	Color Copying Black & White Copying Color Printing Black & White Printing PC Faxing Plain Paper Faxing Other If other please specify
Multiple Functions: Indicate all functions you need now:	Color Copying Black & White Copying Color Printing Black & White Printing PC Faxing Plain Paper Faxing Scanning Other:
Do you currently have an office computer networking system (Local Area Network)?	Yes No
If you currently have an office network system: Indicate type(s) of operating system(s) you use?	Windows 95/98 Windows NT Windows 2000 Server Linux Novell Other
If you currently have an office network system: What type of network topology do you have?	Ethernet Token-Ring 10Base2 Other If other please specify
Do you want the system to be capable of operating on an office network (Local Area Network)?	Yes No Optional
Indicate all paper sizes that you wish to have the ability to print:	Statement (5.5x8.5) Letter (8.5x11) Legal (8.5x14) Ledger (11x17) Other
Do you need Zoom/Reduce & Enlargement? (This allows you to print/copy a document at a size different than the original document.)	Yes No Optional
Do you need automatic 2-sided copying/printing? (Duplexing - Prints/copies both sides of the paper in one operation)	Yes No Optional
What volume of documents will the system need to process? Choose the selection that best describes your needs now or your future anticipated needs that you want to plan for now.	Less than 2000 per month 2000 to 4000 per month 4000 to 6000 per month Over 6000 per month Other If other please specify
Indicate any document finishing options you need:	10 Bin Sorter 10 Bin Staple Sorter 20 Bin Sorter 20 Bin Staple Sorter Folder 3 Hole Punch Unit Other
You can enter the makes and models of any equipment you now own and we will advise you on the possibilities and estimated costs for updating your current equipment to the specifications you need. Note: This could save you a lot of money!
Would you be interested in remanufactured or reconditioned equipment if it is available? Note: This could save you a lot of money!	Yes No Optional

How would you prefer for EBMonline to contact you?

Email
Phone
Fax
Regular Mail
Onsite Sales Visit (Local Only)

What system are you currently using, if any?

Priority:

Best Value
Lowest Price
Highest Quality

You may indicate any budget restraints:

Undecided
Less that $1000
Less that $2000
Less that $3000
Less that $4000
Less that $6000
Interested in Leasing Options

Other

I prefer to have estimates for:

Purchase
Lease
Both Purchase and Lease

Choose the PRIMARY function of the system you need:

Color Copying
Black & White Copying
Color Printing
Black & White Printing
PC Faxing
Plain Paper Faxing
Other

If other please specify

Multiple Functions:
Indicate all functions you need now:

Color Copying
Black & White Copying
Color Printing
Black & White Printing
PC Faxing
Plain Paper Faxing
Scanning

Other:

Do you currently have an office computer networking system (Local Area Network)?

Yes
No

If you currently have an office network system:
Indicate type(s) of operating system(s) you use?

Windows 95/98
Windows NT
Windows 2000 Server
Linux
Novell

Other

If you currently have an office network system:
What type of network topology do you have?

Ethernet
Token-Ring
10Base2
Other

If other please specify

Do you want the system to be capable of operating on an office network (Local Area Network)?

Yes
No
Optional

Indicate all paper sizes that you wish to have the ability to print:

Statement (5.5x8.5)
Letter (8.5x11)
Legal (8.5x14)
Ledger (11x17)

Other

Do you need Zoom/Reduce & Enlargement?
(This allows you to print/copy a document at a size different than the original document.)

Yes
No
Optional

Do you need automatic 2-sided copying/printing?
(Duplexing - Prints/copies both sides of the paper in one operation)

Yes
No
Optional

What volume of documents will the system need to process?
Choose the selection that best describes your needs now or your future anticipated needs that you want to plan for now.

Less than 2000 per month
2000 to 4000 per month
4000 to 6000 per month
Over 6000 per month
Other

If other please specify

Indicate any document finishing options you need:

10 Bin Sorter
10 Bin Staple Sorter
20 Bin Sorter
20 Bin Staple Sorter
Folder
3 Hole Punch Unit

Other

You can enter the makes and models of any equipment you now own and we will advise you on the possibilities and estimated costs for updating your current equipment to the specifications you need.
Note: This could save you a lot of money!

Would you be interested in remanufactured or reconditioned equipment if it is available?
Note: This could save you a lot of money!

Yes
No
Optional

All company names, product names, trademarks, logos, and graphics are property of their respective owners
Domestic Sales Only. Products subject to availability. Prices subject to change without notice.
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