First Name *:
Last Name *:
Company *:
Company Web Site:
Address 1 *:
Address 2:
City *:
State/Province :
Zip/Postal Code *:
Country *:
E-mail Address *:
Phone *:
Fax:
Your system will be set up with one up to three Programming Algorithms for the following devices:
Manufacturer *:
Device *:
Manufacturer:
Device:
Manufacturer:
Device:

As soon as we receive your completed request form, we will contact you back and send you the FlashRunner system most suitable for your needs, factory set up with a programming algorithm for the device you specified. The evaluation period begins on the day you receive the system. If, after 30 days, you decide not to purchase the FlashRunner system, simply return the product in good condition in its original packaging. If you do not return the product within 7 days of the end of the 30-day period, we will consider the product accepted by you and invoice you according to the list price of the product at the time it was issued.