IntelliBar Printer Service Contract Order Form

 To purchase or renew an IntelliBar Service Contract please complete the form below. All fields with an asterisk (*) are required fields and must be completed in order to process your request. Upon receipt and approval of your request by IntelliTech, the requested Service Contract will be forwarded to you along with an invoice for the Contract.

For Service Contract descriptions and pricing, visit the Enhanced Sevice Contract or Standard Service Contract pages. You may also contact IntelliTech Sales online or speak with an IntelliTech sales representative at (978) 212-7200.

*indicates a required field
Contact Information
     
* First Name: *Last Name:
*Company Name:
*Street Address:
*City: *State: *Zip:
Country:

*Telephone:

 Fax:
*Email Address:
Printer and Contract Information
     
*IntelliBar Model: *Serial Number:
*Type of Contract: *Please indicate the number of years you wish to renew or sign-up for this contract: