Project Registration

PROJECT REGISTRATION

Please complete the following form to register a project or to receive a quote.

Dealer Name*
Contact Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Project Information
Please provide information related to this project bid.
Project Name*
Project Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Expected Decision Date*
MM slash DD slash YYYY
Target Installation Date*
MM slash DD slash YYYY
Architect / Consultant
Are AVTEQ products requested by end user?
- Yes
- No
Which distributor do you plan on ordering from?*
- Exertis | Almo
- ScanSource
- TD SYNNEX
- TD SYNNEX Canada
- Direct from Avteq
End User Information
Please provide information about the end user company.
Company or Organization Name*
End User Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
End User Contact Name
First Last
End User Title
End User Phone
End User Email
Products to Quote
- Quantity
- Product Number
- Additional Information
- Number
- Product Number
- Additional Information
- Number
- Product Number
- Additional Information
- Number
- Product Number
- Additional Information
- Number
- Product Number
- Additional Information
Phone
This field is for validation purposes and should be left unchanged.

We’re here to help. Please give us a call with any questions you may have about registering a project.