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Materion Device Request
Your Name
(Required)
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(Required)
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(Required)
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State
ZIP Code
Internal Location of Device
(Required)
Cost Center #
(Required)
Does this device need to be Multi-Function?
(Required)
— Choose One —
Yes
No
Does the device need to be able to Copy & Scan?
(Required)
— Choose One —
Yes
No
Does this device need to print on 11×17 size paper?
(Required)
— Choose One —
Yes
No
Will this device need staple and hole punching
(Required)
First Choice
Second Choice
Third Choice
Do you need a Black & White or Color device?
(Required)
— Choose One —
Black & White
Color
Is there a printer nearby that can be used within the vicinity?
(Required)
— Choose One —
Yes
No
Is this device replacing an existing device?
(Required)
— Choose One —
Yes
No
What is the existing device model, serial # and location?
(Required)
How many pages do you expect this new device to print per month?
(Required)
Will this device need to be floor standing or a desktop?
(Required)
— Choose One —
Yes
No
Do you need any extra trays on this device?
(Required)
— Choose One —
Yes
No
How many extra trays will this device need?
(Required)
Will this device need a card reader?
(Required)
— Choose One —
Yes
No
Will this device be used for printing barcodes?
(Required)
— Choose One —
Yes
No
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