* Name
Title
* Institution
Address 1
Address 2
* City
* State		Zip Code
* Phone
FAX
* E-Mail
URL

1. When do you mail statements?   Select One first week of the month middle of the month other/na

2. What is the average number of accounts to be mailed?
   

   Daily Statements/Invoices:
   Weekly Statements/Invoices:
   Monthly Statements/Invoices:
   Quarterly Statements/Invoices:

   
   Other, please specify quantity and frequency:

3. What is the average number of printed pages per account?
   

   Daily Statements/Invoices:
   Weekly Statements/Invoices:
   Monthly Statements/Invoices:
   Quarterly Statements/Invoices:

   
   Other, please specify quantity and frequency:

4. How are pages printed (not including pre-printed information)?   Select One One side of the form (simplex) Both sides of the form (duplex)

5. Would you like FISC to include forms in the pricing proposal?
   If yes, do you use a pre-printed form?   Yes    No
   If you do use a pre-printed form:
   Is there pre-printed information on one or both sides of the form?   One side    Both sides
   How many colors are pre-printed on each side of the form (including black)?
     Front:       Back: 

6. Are you interested in electronic statements (iE-Statement)?   Yes    No

7. How did you hear about FISC?
   

Please fax us a copy (front and back) of an existing statement. Please remove any confidential information before sending. Fax this information to FISC's Marketing Department at 207.777.6026. Should you have any questions, please call 207.782.6858.

Reminder:
Do not include account numbers or other sensitive information in your request, as this form is not a secure method of communication.