First name:	Last name
Company:	Address:
Email:	Phone number:
Mobile phone:

---

2. Scanner options

Which type(s) do you want? (Eg. 1D/2D/RFID/..)

If 1D, which ISO Code?

If RFID, which frequency's do you want it to support? (Eg. UHF, HF, LF)

Bluetooth support?

YesNo

RS232 support?

YesNo

Wireless support?

YesNo

USB support?

YesNo

Keyboard Want?

YesNo

Scan range? (Centimeters)

ATEX Approved?

YesNo

If ATEX Approved, which certificate do you require?

Gas/Dust resistant?

YesNo

If so, which IP-Certificate do you need?