Inquiry Form
| Title (Mr, Ms, Dr): | |||
| Name*: | |||
| Company*: | |||
| Job Title*: | |||
| Address1*: | |||
| Address2: | |||
| City*: | |||
| State*: | |||
| Zip/Postal Code: | |||
| Country*: | |||
| Phone*: | |||
| Fax: | |||
| E-mail*: | |||
Your business:
Manufacturer:
Printers, copiers, fax/multifunction machines
Toner/ink cartridges
Photoreceptors, charge/bias rollers, other printer components
Toners/inks
Chemicals/resins
Print media
Distributor of parts/supplies
Remanufacturer/recycler of toner cartridges
Research/testing laboratory
Other: (please specify)
Your techology:
Electrophotography
Inkjet
Thermal
Flexo
Other: (please specify)
Your application:
Production/manufacturing
Research and development
Marketing/competitive benchmarking
Cartridge remanufacturing
Other: (please specify)
Does your company currenty use QEA equipment?
Yes No
What do you want to test?
Print quality
Color quality
Flexo plates
Metal backed plates
ITR sleeves
OPC drums
Charge/bias rollers
Development/magnetic rollers
Transfer rollers
Fuser rollers
Toner fusing
Other: (please specify)
Manufacturer:
Printers, copiers, fax/multifunction machines
Toner/ink cartridges
Photoreceptors, charge/bias rollers, other printer components
Toners/inks
Chemicals/resins
Print media
Distributor of parts/supplies
Remanufacturer/recycler of toner cartridges
Research/testing laboratory
Other: (please specify)
Your techology:
Electrophotography
Inkjet
Thermal
Flexo
Other: (please specify)
Your application:
Production/manufacturing
Research and development
Marketing/competitive benchmarking
Cartridge remanufacturing
Other: (please specify)
Does your company currenty use QEA equipment?
Yes No
What do you want to test?
Print quality
Color quality
Flexo plates
Metal backed plates
ITR sleeves
OPC drums
Charge/bias rollers
Development/magnetic rollers
Transfer rollers
Fuser rollers
Toner fusing
Other: (please specify)
In the response boxes below, please provide as much detail as you can.
If yours is a unique application or special requirement not reflected in the check lists above, please contact us! We specialize in devising the solutions our clients need.
What would an equipment purchase
help you achieve?
Additional comments:
What is your role in equipment purchasing decisions?
Evaluate/recommend equipment for purchase.
Approve/make equipment purchase decisions.
Other: (please specify)
When do you expect a decision to be made?
3 months
6 months
12 months
More than 12 months
Don’t know
How did you hear about QEA?
Other:
(please specify)
Please type "QEA" here:* (to prevent spam)
Additional comments:
What is your role in equipment purchasing decisions?
Evaluate/recommend equipment for purchase.
Approve/make equipment purchase decisions.
Other: (please specify)
When do you expect a decision to be made?
3 months
6 months
12 months
More than 12 months
Don’t know
How did you hear about QEA?
| Trade show/conference | (please specify) | |
| Publication | (please specify) | |
| Customer referral | (please specify) | |
| Internet | (please specify) |
Please type "QEA" here:* (to prevent spam)

