Robot Registration Form

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Registration Information

Customer type *

System integrator
End User

First name *

Last name *

Company *

E-mail *

Robot model *

e.g. R-2000iB/165F

Serial no. *

e.g. E-12345 or F-123456

Installation date *

e.g. 25-02-2003

Application *

e.g. handling, arc welding

Industry *

e.g. paper, rubber,...

Installed at (Company Name of End User) *

Address 1 *

Address 2

Zip *

City *

Country *

Contact person at End User

E-mail of Contact Person

Phone Number of Contact Person

Description

(*) Required fields