CD REQUEST FORM

This will allow us to know where to mail a CD to you that will have lots of information on it.
Including:
an autorun CD which will have:
Our Training Presentation, a quick complete how to set up and run a SEWER RAT® SYSTEM. (mainline pipe).
Our SEWER RAT® Promo presentation, showing the advantages, equipment, and accessories for mainline inspection.
Our Li'l rat® Promo presentation, showing the advantages, equipment, and accessories for lateral line inspection.
Our Manhole Rat® Promo presentation, showing the advantages, equipment, and accessories for Man Hole inspection.

It will also have presentations on exciting new products that Empire Industries, Inc. is now shipping to the non municipal market.

Please provide the following contact information: * denotes required information for CD response

First Name	*
Last Name	*
Title
Organization	*
Street Address	*
Address (cont.)
City	*
State/Province	*
Zip/Postal Code	*
Country
Work Phone	*
FAX
E-mail	*

CD REQUEST FORM

Copyright © 1999, 2000, 200, 2002, 2003 Empire Industries, Inc. All rights reserved. Revised: September 23, 2003

Copyright © 1999, 2000, 200, 2002, 2003 Empire Industries, Inc. All rights reserved.
Revised: September 23, 2003