Customer Registration

First Name*   Last Name*  
Address 1*  
Address 2  
City*   State*  
Main Phone #*   Alt Phone #  
Where was your computer purchased?  
Order #   Serial #*  
  (* is required)  

Consent to release Personal Information

I understand that by signing this form, I grant Joy Systems, Inc to discusss and/or release the above personal information to the third parties [person(s) or entities] such as affiliates of Joy Systems, Inc, its agents and service provider(s) to use as they see fit. Information regrading special needs are excluded from this authorization, and will not be released without specific written authorization.