


















    
----------------------------< Plier selon le pointillé >----------------------------

                          Fax (USA/Canada)  : (1-888)979-76-62
                          Fax (autres pays) : (+1-978)531-06-75

    XXX:ALSXXXSXAAAS 

    Registration:  $(system.return)              Date: $(system.date)

    First Name: $(Register.201,15,EDIT)    MI: $(Register.202,2,CHARCAPS)
    Last Name:  $(Register.203,30,EDIT)            
    Title:      $(Register.204,30,EDIT)
    Company:    $(Register.205,30,EDIT)            
    Address:    $(Register.213,50,EDIT)          
    Suite:      $(Register.214,20,EDIT)           
    E-mail:     $(Register.221,40,INETADDRESS)            
    City:       $(Register.215,50,EDIT)              
    State/Prov: $(Register.216,20,EDIT) 
    Zip/Postal: $(Register.217,15,NUMCAPS)
    Country/Région: $(Register.218,50,COMBOBOX)               
    Phone Area: $(Register.219,3,NUMERIC)   Phone Number:   $(Register.220,10,SSNO)  Extension:  $(Register.208,4,NUMERIC)
    Serial Num: $(Register.207,25,ALPHANUM)  

    Learn Yes:  $(Register.10000,3,RADIO)            Learn No: $(Register.10001,3,RADIO)            
    Pers Use:   $(Marketing.6001,6,CHECKBOX)     Business Use: $(Marketing.6002,6,CHECKBOX)             
    Bus. Type:  $(Marketing.14001,50,DROPDOWNLISTBOX)                   
    
----------------------------< Plier selon le pointillé >----------------------------
 
    Employee 1: $(Marketing.10002,3,RADIO)       2-10: $(Marketing.10003,3,RADIO)         11-100: $(Marketing.10004,3,RADIO)    100+: $(Marketing.10005,3,RADIO)            
   
    Scanner Br: $(Marketing.14000,25,DROPDOWNLISTBOX)            
    Upgrade:    $(Marketing.10006,3,RADIO)        No Upgrade:       $(Marketing.10007,3,RADIO)            
    Contact:    $(Marketing.10008,3,RADIO)        No Contact:       $(Marketing.10009,3,RADIO) 
 
    Product Code:  $(Info.Product Code,20,EDIT)
    Language:      $(Info.Language,5,EDIT)
    Version:       $(Info.Version,5,EDIT)
    Channel:       $(Info.Channel,5,NAME)
        
    XXX:ALSXXXSXAAAS
