To take advantage of the benefits of MOMENTUM, please provide us with the following information:

Your Name
Company Name
Address
City
State
Zip
Phone
Fax
E-Mail Address
Website
	Do you sell:
	Software    Hardware    Both
	What Printer brands do you currently sell?
	Ithaca    Epson    Star    Citizen    Other
	What types of printers do you sell?
	Thermal    Inkjet    Impact
	What Ithaca printers do you sell?
Thermal:	Model 80PLUS iTherm 280
Inkjet:	POSjet® 1000 POSjet® 1500 BANKjet® 1500 KITCHENjet® 1000
Impact:	Model 150 Model 90PLUS