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Product Registration
First Name
Last Name
Address #1
Address #2
City
State
Zip
Country
Item Purchased
Lan Pass 115
Lan Pass 125
Lan Pass 250
Fast Switch 200
Fast Switch 400
LG 10Mpbs
LG 10Mpbs/w
LG 100Mpbs
LG 100Mpbs/w
Purchase Date
Serial Number
Used For (check one)
Home
Business
Charity
Government
Educational Institution
Network Operating System (check all that apply)
NetWare
Banyan Vines
Windows
IBM Lan Server
PC/NFS
Comments
LanGear Inc. 414 Wittlow Way Farley, SD 85312 1 (800) 555-2377