B&K Precision Educational Promotion Eligibility Form V092514 Bk

: Bk Bk Precision Educational Promotion Eligibility Form bk_ precision_educational_promotion_eligibility_form bkprecision s

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Educational Promotion Eligibility Form
Educators are entitled to 10% off the B&K Precision published list price on all orders placed with
an authorized distribution partner. Orders must total $5,000 or more in qualifying B&K Precision
products, and must include a copy of this completed eligibility form and a proof of purchase.

Contact	
  Information	
  *	
  
	
  Educational	
  	
  
	
  Institute:	
  	
  

	
  

	
  Address:	
  	
  
	
  
	
  
Technical	
  Contact	
  (include	
  information	
  about	
  the	
  individual	
  that	
  specified	
  the	
  purchase	
  or	
  main	
  
end-­‐user)	
  *	
  
Name	
  :	
  	
  
	
  
Title	
  :	
  	
  
	
  
Email	
  Address	
  :	
  	
   	
  
Phone	
  :	
  	
  
	
  
	
  
Model	
  /	
  Quantity	
  Purchased	
  *	
  
	
  	
  
	
  	
  
	
  
Serial	
  Number(s)	
  
	
  	
  
	
  	
  
	
  	
  
	
  
Please	
  provide	
  a	
  short	
  description	
  of	
  your	
  application	
  (using	
  the	
  above	
  instruments)	
  *	
  
	
  	
  
	
  	
  
	
  	
  
	
  	
  
	
  	
  
	
  	
  
	
  
Would	
  you	
  like	
  to	
  receive	
  email	
  updates	
  with	
  information	
  about	
  new	
  product	
  
	
  Yes	
  
releases,	
  application	
  notes,	
  how-­‐to	
  guides,	
  and	
  special	
  promotions?	
  	
  
How	
  did	
  you	
  hear	
  about	
  this	
  promotion?	
  *	
  
	
  	
  
	
  
	
  
*	
  Mandatory	
  fields	
  

v092514



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Page Count                      : 1
PDF Version                     : 1.4
Title                           : Microsoft Word - B&K Precision Educational Promotion Eligibility Form v092514.doc
Author                          : Marc Karsten
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Creator                         : Word
Create Date                     : 2014:09:25 14:49:25Z
Modify Date                     : 2014:09:25 14:49:25Z

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