Machine Model
Serial Number
Install Date
Control Model
Control Ser. #
Dealer Name

Contact Information:

Contact Name
Company
Street Address
Address (cont.)
City
State/Province
Zip Code
Country
Phone
FAX
E-mail
URL

How did you hear about Chevalier?

Print Ads
Website
Mailer
Dealer
Referral
Trade Show
Other:

What influenced you to purchase Chevalier ? (Please check all that apply)

Price
Special Package Pricing
Quality
Dealer Support
Delivery
Previously bought a Chevalier and is happy with its performance

If you previously bought a Chevalier, what type and model was it?

What additional machines do you plan to purchase
 in the future?

Manual Mill
CNC Knee Mill
CNC Bed Mill
VMC
Manual Lathe
CNC Lathe
Manual Grinder
Automatic Surface Grinder
CNC Grinder
Cylindrical Grinder
Tool & Cutter Grinder

Number of employees in you company:

1-49
50-99
100-499
500-up

What is the primary product or service performed at
 this location?