Title:           
MR.MS.

First Name:      
Last Name:       
Company Name:    
Company Address: 
City:            
State/Province:  
ZIP:             
Country:         
E-mail:          

                 country  area    number
                 code     code
Telephone:         
Fax:               

WHICH OF THE FOLLOWING BEST DESCRIBES YOUR COMPANY ACTIVITY:

END USER OF MOBILE COMPUTERS
RESELLER/VAR OF MOBILE COMPUTERS
SYSTEM INTEGRATOR OF MOBILE COMPUTERS
MANUFACTURER OF MOBILE COMPUTERS
OTHER

OTHER (please specify): 

YOUR JOB TITLE (please specify): 

YOUR PRINCIPAL JOB FUNCTION:

GENERAL CORPORATE MANAGEMENT
MARKETING MANAGEMENT
SALES MANAGEMENT
ENGINEERING MANAGEMENT
MANUFACTURING MANAGEMENT
PROJECT MANAGER
SOFTWARE DEVELOPMENT
OTHER

OTHER (specify): 

NUMBER OF EMPLOYEES OF YOUR COMPANY     

ANNUAL TURNOVER OF YOUR COMPANY IN US $ 

APPLICATIONS OF YOUR INTEREST (check all that apply):

SALES AND RETAILING
Route Accounting                 Van Sales
Order Entry                      Door to door sales
Duty free sales on aircraft      Wholesales

SERVICES
Electricity Meter Reading        Gas Meter Reading
Water Meter Reading              Parcel Dispatching
Parking Fine Issuing             Travel Ticket Issuing
Customer Field Service

MANUFACTURING
Receiving Shipping Goods         Shop-floor data acquisition
Inventory control                Assets control
Plant maintenance                Time and attendance

OTHER APPLICATIONS
please specify: 

PRODUCT OF YOUR INTEREST:

                           QUANTITY     WITHIN                 
                                        (No OF MONTHS)         
FDA600                             
FDA300                             
DAT500                             
DAT400                             
DAT300                             
DAT300-EX                          
ORION: GPS+GSM/GPRS                
RFID                               
BEST SALE 300                      

DID YOU USE OR ARE YOU USING OTHER MOBILE COMPUTER? 
NO
YES

(IF YES) WHICH BRAND NAME:                          

HOW DID YOU KNOW OUR COMPANY:
OUR CUSTOMER                               INTERNET
ADVERTISING ON (please specify the review) 
MAILING                                    TRADE SHOW
OTHER (PLEASE SPECIFY)                     

YOUR INTEREST IS IN:
LITERATURE ON OUR PRODUCTS
ENTRY IN OUR MAILING LIST FOR REGULAR PRODUCT UPDATES
INQUIRY AS A POTENTIAL DISTRIBUTOR
  FOR THE FOLLOWING COUNTRY/AREA 
PRICE LIST
SALES REPRESENTATIVE CONTACT
OTHER (please specify)         

Comments:



Our head office address:

        4P MOBILE DATA PROCESSING
        Via Germania 7
        35127 PADOVA - ITALY
        tel + 39 049 8069.811
        fax + 39 049 8069.843
        E-mail: 
        Web: www.4p-online.com



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