Complete form to activate your Dukane AV Warranty

*Required Fields
Customer Information
*Name: (First) (Last):
Phone: Ext: Fax:
Decision Maker of AV purchases:
Name: Title:
Product Information
*Model:  You may enter multiple warranties (up to 15) on one page as long as they are the same model number.
*Serial:  Separate serial number entries with a comma.
*Date Purchased:
Miscellaneous Information
Organization Type: Other:

Primary Use of Product: Other:

Type of Product Purchased: Other:

Where was the Product purchased: Other

Do you Travel with this product: Yes      No

How did you first learn of the Product:

What is the number one reason you chose Dukane presentation products: Other

What Dukane Products have you purchased in the past: