Binder Minder®

Information Request Form

Please complete this form to request more information about Binder Minder®

1.0 Your Name
1.05 Business Name
1.1 Street Address,
or P.O. Box:
1.13 City
1.17 State/Province
1.18 Country
1.19 Zip
1.2 Phone:
1.3 Fax:
1.4 Your Email:
2.1 Your organization's name:
2.2 What type of business are you in?  Library
 College or University
 Office Machine Dealer
 Dealer
 Manufacturer
 Consumer
Other: 
2.3 Brand of Copier
2.4 Model of Copier
2.5 Are you currently using Binder Minder®? Yes 
No 
2.6 Please send:   Wholesale Price list (dealers only)
  Brochure
4.0 Specific comments and Inquiries:

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