BenQ ProAV Deal Registration Form
 * Required
End User Contact Information:
End User Name:*
End User State :*
End User Contact Person
First Name:*
Last Name:*
Email Address :*
Phone Number :*
Opportunity Specifics
ProAV Model Number:*
Quantity:*
Target Reseller Price:*
 
Target End User Price:
 


Preferred Distributors:*



Notify Distributor about this deal? :*
Need BenQ Sales Rep. to contact:  
I have a Rep:
Special Warranty Requirement:

[notice our standard
warranty is 3 year for deal]
Bid Close Date :*  
Bid Delivery Start Date:*  
Total Months of Delivery:
End user consider other brands:?*  
Additional Comment:
Reseller Information
 
Send e-mail acknowledgement to:*  
Reseller Business Name:*
Reseller Contact Person's First Name:*
Last Name:*  
Reseller State:
Email:*  
Phone Number:*
Fax Number:
Is it first time registering the deal with BenQ?:
Offer Technical Service:
Offer Installation Service:
I would like to receive:*  
 




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