| Fill out
the following fields, then click the submit button below.
(Required fields indicated with an asterisk *)
For WCAS
product details, features, and options, click
here . |
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*
Full Name:
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| * Company: |
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| * Title: |
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* City,
State, Country
(e.g., Miami,
FL, USA): |
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|
Website: |
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| * Email: |
(Valid
address
required so we can issue a reply.) |
* Telephone
|
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|
Promo code (optional) |
|
| * Provide a
brief description
of your application. |
|
| * Number of WCAS controllers needed? |
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| * Does the location have a network with sufficient wireless
access points (i.e., routers, etc)? |
|
| * What is the approximate distance from the reader to the
nearest wireless access point? |
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* Reader type (i.e., magstripe or proximity)?
|
|
| * Do you have existing reader(s)? |
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| * Number of reader(s) desired for purchase? |
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| * Do you have existing cards? |
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| * Number of cards needed (min = 100)? |
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| * Card details (format, brand, frequency, etc.)? |
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| How did
you discover this product? |
Name of publication or referral:
|
| * What is
your need-date
for this product? |
|
| * Describe
any future
needs for additional product quantities and/or support ?
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| Comments: |
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