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If you are not connected to the internet please print this form and send via fax to the number listed above.

Company Information

Company Name

 

Contact Person

 

Address

 

City / State / Zip

 

Phone Number

 

Fax Number

 

Company web site (if available)

 

Return E-mail Address

 





General Information

Number of employees?

Total square footage?

How many floors (levels)?

How many shifts per day?

How many employees per shift?

How many departments?

Number of access doors?

Are there different levels of access?

explain:

Company hours of operation?

Is site security required?

Do you have a problem with employee abuse?

explain:

 

Payroll Information

What Payroll service do you use?

Number of man hours dedicated to payroll?

Does company process own payroll?

 

What Time and Attendance does your company use?

 

Network Architecture

Ethernet?

Unix?

AS 400?

 

If other please specify below

 

What type cable is currently installed?

 

Network Operating System

Novell (Version)?

Windows (Version)?

Unix (Version)?

 

If other please specify below

 

 

Leasing

Would you like to lease CheckPrint T/A?

 

 

On-Site Demo

Please schedule my company for an On-Site Demo?

 

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