System Quote - Dactek

Please complete the following form and we will respond with a system quote.
Your Name*:
Organization*:
Email Address*:
Phone*:
Fax:
Street Address:
Address 2:
City:
State:
Postal Code:
Country:

Quantity of badges:
Time period:
Number of locations to be badged:
Camera Preference:	Digital Video Unsure
Portable System:	Yes No Unsure
Print Color:	B&W Color
Sides Printed:	Single Dual Unsure
Card size:	Credit Card Oversize
Secure overlaminate:	Yes No
Design:	Objects on Card Cardholder Name ID Number Expiration Date Institution's Name Logo Signature Other	(Check all that apply)
Photo:	B& W Color Ghosted Chromakey	(Check all that apply)
Bar Code:	Yes No
Magnetic Strip:	Yes No
Proximity Card:	Yes No
SmartCard:	Yes No
Reports Required:	Yes No
Source of Data:
Local Area Network in place?	Yes No
OS Platform:
When is it needed?
Additional requirements or considerations:
Respond via:	Email Phone Fax