Registration FAX Form

You are now the owner of TRIATEK's new Product Catalog. Inside, you will find the best values in controls. But first, please take the time to register yourself so that we can send you announcements on new products and updated catalogs as they become available.

Please add my name to your mailing list for future catalog editions and new product announcements.

Name_______________________________________

Title________________________________________

Address_____________________________________

City________________________________________

State/Country_________________________________

Zip_________________________________________

Phone (area code)_____________________________

Fax_________________________________________

Email_______________________________________

I need another catalog!

Please add my colleague's name to your mailing list:

Name_______________________________________

Title_________________________________________

Address_____________________________________

City_________________________________________

State/Country__________________________________

Zip__________________________________________

Phone (area code)______________________________

Fax__________________________________________

Email________________________________________

Internet_______________________________________

 Yes! I want your CD catalog when it is available!

It is just like this catalog but in an electronic format. Information can be searched electronically to find the product that meets your application. It utilizes point and click selection for each product. You can print data sheets to your printer, too!

DO NOT REMOVE

Copy and FAX completed form to: