<%@LANGUAGE="JAVASCRIPT" CODEPAGE="1252"%> Information Request Form

Thank you for visiting Intec USA. If you would like additional information about our product and services, please complete the form below and fax it to (919) 433-0140 and a sales representative will be in touch within 24 hours.

1. What industry does your company represent?
Beef Pork Poultry Cheese Ice Cream Bakery Eggs
Poultry Frozen Entrees other

2. How soon are you looking at implementing a new system?
within 6 months 6-9 months 9-12 months no immediate plans

3. How would you like to be contacted?
Please contact me by phone
Please send me material on your product and services

Name
Company
Address
City
State
Zip Code
Telephone
E-Mail Address

Please provide any additional information below