F4X ELECTRONIC MESSAGE CENTERS BY FORMETCO

THIS IS REQUIRED FOR ALL EMC INSTALLATIONS

Please complete this form below to the best of your ability. Accurate information will ensure that no problems are encountered after a registration.

INFORMATION ON COMPANY WHO PURCHASE SIGNS (REQUIRED)

Sign Company Name:

Sign Company Contact:

Sign Company Shipping Address:

City / State / Zip:

Sign Company Phone:
Sign Company Email:

Did your company directly handle the installation? Choose YES if you did.
If you sub-contracted installation to a third party select NO.
YES

INFORMATION ON CUSTOMER WHERE SIGN IS INSTALLED (REQUIRED)

End User Business Name:

End User Physical Address:

City / State / Zip:

End User Contact Name:
End User Contact Phone:
End User Email:

SIGN INFO (REQUIRED)

Date of Installation: Serial #:
Communication Type:
Sign Access Height (To Top of EMC):

Before pressing submit. Please double check your entries to ensure that all information is correct. Once registration is submitted you will not be able to make changes.