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First Name Last Name
E-mail Company
Title Work Phone 
 
Street Address Address (cont.)
City State/Province 
Zip/Postal Code Country 

Product Serial No is an 8-digit number proceded by an MM. This may be found on a sticker on the hardware. Example: MM12345678
Product: Product Serial No
Platform: Where did you buy your product:
How do you plan to use video:(Check all that apply)
Business TVMusicCorporate CommunicationNews Delivery
Distance LearningSecurity/SurveillanceEncoding Services TVTelemedicine
EntertainmentTrainingInternet BroadcastVideo Conferencing
Live WebcastingWeb Video Content ProductionMultimedia PresentationOther(Specify)
 
What video format do you capture? (Check all that apply.)
Windows Media(wm)Real Helix(rm)Flash Video(flv)QuickTime(qt)
DVAVIOther(Specify)
 
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