Sunday, February 12
	Note: An asterisk (*) indicates a required field. If necessary, you can refer to the guidelines at the end of the form for assistance in filling out this form. (1) General Customer Information: *  Name *  Account Number   Phone   Fax *  Email   *  Country --select one-- Argentina Brazil Chile Colombia Dominican Republic Mexico Miami Panama Peru Puerto Rico Uruguay Venezuela * Preferred language to use:     English      Spanish      Portuguese  (2) Customer contact profile: Account Manager:   Phone   Fax   Email   Customer Service contact:   Phone   Fax   Email   IT contact:   Phone   Fax   Email   (3) Information related to KODAK BISNET Exchange  PC Specifications:   Brand   Model   CPU Type   Memory (RAM) Hard Drive:   Size   Available Space Modem:   Brand   Speed Windows OS Version:   Access to Internet:    YES     NO  If you answered yes, please fill in below:    Name of Local Internet Provider      Type of Connection:      Modem        LAN      Internet Browser Used:     Internet Explorer     Netscape     Version  Reference Guidelines for filling out this form: General Customer Information: • Fill in the information about your company. The "Account Number" is your Kodak Customer Account. Customer contact profile: • The "Account Manager" is typically the immediate supervisor of the person responsible for placing orders with Kodak. It could also be owner of your business. • The "Customer Service contact" is the person responsible for placing orders with Kodak. • "IT Contact" - If your company has anyone that is responsible for providing support for your computers, networks, etc., please identify this person in the event that our technical people need to talk with your technical people. Information related to KODAK BISNET Exchange: • Please help us understand the hardware that will be supporting the use of KODAK BISNET. If provided, this information will assist us with understanding the behaviors of the application as it operates on your computer should technical support become necessary from Kodak. • Make sure your preferred language is filled in and is correct. Your account will have this characteristic and therefore, drive the language that you will see on the KODAK BISNET screens as well as in the E-mail feedback that your will receive directly from Kodak. • Do you have internet access today? Specifically, we are asking if you currently have an account with a local ISP open (an ISP is a Internet Service Provider such as AOL, etc.). • Access to Internet: Provide this information only if you currently have a Internet account opened. Your Browser and software release level is very important: • To access KODAK BISNET, you much use either the Microsoft Internet Explorer Browser or the Netscape Internet Browser - see version requirements that follow: Netscape Internet Browser - Minimum software release level is 3.0. Microsoft Internet Explorer Browser - Minimum software release level is 4.0. • In the processing of your KODAK BISNET transactions, the Kodak business systems will be preparing your processing feedback and returning this information to you via Internet E-mail. The Internet address provided here will become the E-mail account that Kodak will use to sent the KODAK BISNET information back to you. • If you commit to using KODAK BISNET to place orders with Kodak, Kodak enable your account to receive electronic e-mail copies of your Invoices and your monthly account statement. These e-mail copies will NOT replace the paper-copies that you now receive.		MAIN PAGE What is KODAK BISNET Exchange? KODAK BISNET Exchange Features Minimum Computer Requirements Demo Training Questions? Contact Us Open Your Account!

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