Pre-Registration Form

Distributor Company:_____________________Primary Contact:_________________________
Address:___________________________City/State/Zip:_______________________________
Phone:_______________________Fax:___________________E-mail:____________________

Number of seats required_______
(Note: Each seat represents one computer logging into the seminar)

Scheduled Date/Time (Please specify what Time Zone):
1st Choice: Month_________Day_________Time_________ AM PM Time Zone:______
2nd Choice: Month_________Day_________Time_________ AM PM Time Zone:______
3rd Choice: Month_________Day_________Time_________ AM PM Time Zone:______
(Infomation/sample packets will be sent one week in advance.)

Topic Requested (circle below):

•Blind Sites
•Form/Label
•Integrated Labels
•Phone Card
•Speedy Solutions
•Useal®		 •Commercial/ Promotional Products
•Gift Certificates
•Joined Web
•Plastic Cards
•Tags
•Variable Imaging		 •Digital Printing
•In-Laid Plastic Card
•DuraGloss™ Plates
•Pocket Forms
•Thermal Transfer		 •Document Security
•Integrated Cards
•Magnetic Messages™
•Pressure Seal
•Unit Sets

If you would like a topic other than one listed above, please specify: ________________________

Attendees
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2.______________________________
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4.______________________________
5.______________________________
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7.______________________________
8.______________________________
9.______________________________
10._____________________________
11._____________________________
12._____________________________
13._____________________________
14._____________________________ 		Email
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