SEA Customer Data Form

    General Information:

    Company Name

    Customer Number

    Customer Location / Address

    City

    State/Province

    Postal Code

    Country

    Active Machine Equipment Number(s) (if the customer can provide you with active UIC equipment numbers that would help us update our installed base).




    Primary Manufacturing Management Contact:

    First Name

    Last Name

    Position/Title

    Email

    Phone Number

    Primary Manufacturing Operations/Engineering Contact:

    First Name

    Last Name

    Position/Title

    Email

    Phone Number

    Primary Parts/Service Purchasing Contact:

    First Name

    Last Name

    Position/Title

    Email

    Phone Number

    Customer Attributes:

    Customer Classification

    Primary Industry

    Primary Universal Product (Please select a general UIC product category, particular to this customer facility)

    Secondary Universal Product (Please select a general UIC product category, particular to this customer facility)

    Primary Competitor Equipment (What other competitor equipment is currently installed at this facility, relative to the UIC equipment being installed)

    Secondary Competitor Equipment (If applicable)

    Additional Notes

    Please Type the Code in the Box Below:
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