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Roland DG Academy - Registration

Your Information:
	First Name	*
	Last Name	*
	Work Phone Number	*
	Fax Number
	Mobile Number
	Email	*
			Tick this box to receive updates and general information regarding Roland DG via email
Your Company's Information:
	Company Name	*
	Street Address	*
	Address 2
	City	*
	State / Province	*
	Postal Code	*
	Country	*

	What is your main business activity?
	Label Printer		Screen Printer
	Photographer/Photography Lab		Gift Shop
	Sign Shop		Commercial Printer
	Engraving Shop		Display Graphic Printer
	Design Studio		Fine Art Reproduction
	Reprographics		Apparel/Embroidery
	Other, please specify:

	How many people are employed by your company?		1 - 10 11 - 20 21 - 50 50 or more

	Do you currently use a Roland DG Product?		Yes No Not sure

	Authorised Roland Dealer (if applicable)?

	Machine(s) Used:

	Thinking of upgrading?:		Soon within 6 months 6-12 months not sure

	RIP/Design software used:

	What is your main interest in attending Roland DG Academy?
	Education		Training
	Creative Inspiration		Product Knowledge
	Other - please specify:

	How did you find out about Roland DG Academy?

	Please indicate which date you wish to attend:	*

	What are the main factors influencing your purchase decision?
	Dealer recommendations		Ability to match colours
	Brand		Lower cost of consumables
	Price		Print Width
	Speed & Accuracy		Print and cut capabilities
	Quality		Ability to print on uncoated media
	Other, please specify:


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