*Name:
		
		

			
			
	
	

		

			*Company: 
		
		

			
			
	
	

		

			*Address1:  
		
		

			
			
	
	

		

			Address2:  
		
		

			
			
	
	

		

			*City: 
		
		

			
			
	
	

		

			*State:  
		
		

			
			
			
			 *Zip:
			
	
	

		

			*Phone:  
		
		

			
			
	
	

		

			Fax:  
		
		

			
			
	
	

		

			*Email:  
		
		

			
			
	
	
                 * Required fields
	
	

		

			

				

				How many badging stations will you require?
				
			
		
		

			

			         
				
				
			     Full Systems 
			

				 
				
				
			    Remote Systems
			
				
			
		
		

			

			    

			    
			    How would you like to use the ID system?
								
			
		
		

			

			         
				
				
			    Corporate Badging 
			 
			
			

				
				
				
			    Member IDs 
				
			
		
		

		    
			
			        
				
				
				
			    Student IDs
			
			
			

				
				
				
			    Security Access
				
			
		
		

		    
			
			        
				
				
				
			    Other
			
			
		
		

			

			    

			    
			    Select the features to be included on your card?
								
			
		
		

			

			         
				
				
				
			    Photo 
			 
			
			

				
				
				
			    Magnetic Stripe
				
			
		
		

		    
			
			        
				
				
				
			    Signature
			
			
			

				
				
				
			    Smartcard
				
			
		
		

		    
			
			        
				
				
				
			    Barcode
			
			
			
			
			    
				
				
			    Other
			
			
		
    	

			

			    

			    
			    Which components will you need to purchase for your system?
								
			
		
		

			

			        
				
				
				
			    Computer 
			 
			
			

				
				
				
			    Barcode Scanner
				
			
		
		

		    
			
			        
				
				
				
			    ID Card Software
			
			
			

				
				
				
			    Mag Stripe Reader
				
			
		
		

		    
			
			        
				
				
				
			    Card Printer
			
			
			
			
			    
			    
			    Signature Pad
			
			
		
		

		    
			
			        
				
				
				
			    Digital Camera
			
			
			
			
			    
				
				
			    Slot Punch
			
			
		
		

			

				

				What is the estimated number of cards you will produce annually?

				
				    *
			
		
		

			

			    

			    
			    Will the back of the card design contain variable (personalized) data that will require a dual-side card printer?
			
		
		

			

			         
				
			    Yes 
				 
			
			

				
			    
			    No 
				
			
		
		

			

			    

			    
			    Will the system need to be portable?				
			
		
		

			

			         
				
			    Yes 
				 
			
			

				
			    
			    No 
				
			
		
		

			

			    

			    
			    Will the system be placed on a network?				
			
		
		

			

			         
				
			    Yes 
				 
			
			

				
			    
			    No 
				
			
		
		

			

			    

			    
			    How will you require your database to be handled?				
			
		
		

			

			         
				
			    Type & Go (start from scratch) 
				 
			
			

				
			    
			    Import from existing database 
				
			
		
		

			

			         
				
			    Link to an active database 
				 
			
		
		

			

				

				What is your budget?     
				*
			
		
		

			

				

				When is the system needed by?   
				  
				*  
				(mm/dd/yyyy)