Benchmark Electronic Systems – Product Registration

RESOURCES & SUPPORT – PRODUCT REGISTRATION

Thank you for purchasing a Benchmark Electronics' product. Please fill in the registration form below. It will help us to provide better product and after sales support.

	Fields marked with an * are required. Thank you.
First Name*:
Middle Initial/Name:
Last Name*:
Company/Institute*:
Designation*:
Department :
Address 1 :
Address 2 :
Address 3 :
City*:
State :
Zip/Pin Code*:
Country*:
Phones*:	Area Code Phone Number Extn.
Fax :
E-mail*:	(Enter xx@xx.xx if you do not have an e-mail address)
Product*:
Date of Purchase*:	dd mm yyyy
Comments, if any :
	*These fields are required. Thank you.

QUICK CONTACTS

Beijing:
Phone: (+86-10) 6211 5743
Fax: (+86-10) 6211 5843

Chennai:
Phone: (+91-44) 2496 0227
Fax: (+91-44) 2496 1561

Delhi:
Phone: (+91-120) 466 4900
Fax: (+91- 120) 466 4999

Kolkata:
Phone: (+91-33) 2355 7978

Singapore:
Phone: (+65) 6749 3372
Fax: (+65) 6749 3326