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<head>
<title>Grass Valley Group Product Warranty Registration</title>
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<h2><span class="orgcol-black">Product Warranty Registration</span></h2>
<p>Take a few minutes and find your packing slip and obtain this
pertinent information — and then simply complete the form below.</p>
<script language="JavaScript">
function extrareqd()
{
// Extra Required Variables
xVar = ["item1", "model1", "serial1"];
// Extra Required Descriptions
xDesc = ["Item # 1", "Model # 1", "Serial # 1"];
for (k = 0; k < xVar.length; k++)
{
offset = (k + MyVar.length);
MyVar[offset] = xVar[k];
MyDesc[offset] = xDesc[k];
}
}
</script>
<script language="JavaScript">
<!-- Begin
var MyVar = ["firstn", "lastn", "company", "title", "phone", "email", "address1", "city", "state", "country", "zip"];
var MyDesc = ["First Name", "Last Name", "Company/Organization", "Title", "Phone Number", "Email Address", "Street Address", "City", "State/Province", "Country", "Zip/Postal Code"];
// Allows the page to define any extra data to check for
extrareqd();
function checkrequired(which)
{
var MyMsg ="";
MyMsg += "Please make sure the following\n";
MyMsg += "field(s) were not properly completed:\n\n";
var pass = true;
if (document.images)
{
for (i = 0; i < which.length; i++)
{
var tempobj=which.elements[i];
for (j = 0; j < MyVar.length; j++)
{
if (tempobj.name == MyVar[j])
{
if ( ( (tempobj.type == "text") ||
(tempobj.type == "textarea") ) &&
(tempobj.value == '') )
{
pass = false;
MyMsg += " " + MyDesc[j] + "\n";
}
// check select
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(tempobj.selectedIndex < 0) )
{
pass = false;
MyMsg += " " + MyDesc[j] + "\n";
}
// check radio/checkbox
if ( ( (tempobj.type == "checkbox") ||
(tempobj.type == "radio") ) &&
(!tempobj.checked) )
{
pass = false;
MyMsg += " " + MyDesc[j] + "\n";
}
}
}
}
}
if (!pass)
{
alert(MyMsg);
return false;
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else
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// End -->
</script>
<form onSubmit="return checkrequired(this)"
action="/cgi-bin/catch_prodreg.pl" method="post">
<p class="indent2"><sup><span class="orgcolor1">*</span></sup>
<span class="orgcolor2">Indicates Required Field</span></p>
<table>
<!-- -->
<tr>
<td align="right">First Name<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="firstn" value="" size="25"></td>
</tr>
<tr>
<td align="right">Last Name<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="lastn" value="" size="25"></td>
</tr>
<tr>
<td align="right">Company/Organization<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="company" value="" size="25"></td>
</tr>
<tr>
<td align="right">Title<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="title" value="" size="25"></td>
</tr>
<tr>
<td align="right">Phone Number<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="phone" value="" size="25"></td>
</tr>
<tr>
<td align="right">Fax Number</td>
<td><input type="text" name="fax" value="" size="25"></td>
</tr>
<tr>
<td align="right">Email Address<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="email" value="" size="25"></td>
</tr>
<tr>
<td align="right">Street Address<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="address1" value="" size="25"></td>
</tr>
<tr>
<td align="right"> </td>
<td><input type="text" name="address2" value="" size="25"></td>
</tr>
<tr>
<td align="right">City<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="city" value="" size="25"></td>
</tr>
<tr>
<td align="right">State/Province<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="state" value="" size="25"></td>
</tr>
<tr>
<td align="right">Country<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="country" value="" size="25"></td>
</tr>
<tr>
<td align="right">Zip/Postal Code<sup><span class="orgcolor1">*</span></sup></td>
<td><input type="text" name="zip" value="" size="25"></td>
</tr>
<tr>
<td colspan="2">
<table width="100%" cellpadding="0"
cellspacing="0">
<tr>
<td colspan="2"><hr size="1"
noshade></td>
</tr>
<tr>
<td colspan="2">What role did you play in this purchase?</td>
</tr>
<tr>
<td><input type="radio" name="role" value="Decision Maker"></td>
<td>Decision Maker</td>
</tr>
<tr>
<td><input type="radio" name="role" value="Product Selection"></td>
<td>Product Selection</td>
</tr>
<tr>
<td><input type="radio" name="role" value="Selection Input"></td>
<td>Selection Input</td>
</tr>
<tr>
<td><input type="radio" name="role"
value="None"></td>
<td>None</td>
</tr>
<tr>
<td colspan="2">For Warranty
Registration Please Complete this
Section<sup><span
class="orgcolor1">*</span></sup></td>
</tr>
<tr>
<td valign="top" colspan="2">
<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr>
<td> </td>
<td><b>Item #</b></td>
<td><b>Model #</b></td>
<td><b>Serial #</b></td>
</tr>
<tr>
<td>1</td>
<td><input type="text" name="item1" size="10"></td>
<td><input type="text" name="model1" size="10"></td>
<td><input type="text" name="serial1" size="10"</td>
</tr>
<tr>
<td>2</td>
<td><input type="text" name="item2" size="10"></td>
<td><input type="text" name="model2" size="10"></td>
<td><input type="text" name="serial2" size="10"</td>
</tr>
<tr>
<td>3</td>
<td><input type="text" name="item3" size="10"></td>
<td><input type="text" name="model3" size="10"></td>
<td><input type="text" name="serial3" size="10"</td>
</tr>
<tr>
<td>4</td>
<td><input type="text" name="item4" size="10"></td>
<td><input type="text" name="model4" size="10"></td>
<td><input type="text" name="serial4" size="10"</td>
</tr>
<tr>
<td>5</td>
<td><input type="text" name="item5" size="10"></td>
<td><input type="text" name="model5" size="10"></td>
<td><input type="text" name="serial5" size="10"</td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="2">The product(s) was/were purchased from:</td>
</tr>
<tr>
<td><input type="radio" name="pruchfrom" value="Grass Valley Group Direct"></td>
<td>Grass Valley Group Direct</td>
</tr>
<tr>
<td><input type="radio" name="pruchfrom" value="Reseller"></td>
<td>Reseller</td>
</tr>
<tr>
<td colspan="2">Sales Representative:</td>
</tr>
<tr>
<td> </td>
<td><input type="text" name="salesrep" size="30"></td>
</tr>
<tr>
<td colspan="2">Date Purchased</td>
</tr>
<tr>
<td> </td>
<td><input type="text" name="purchdate" size="30"></td>
</tr>
<tr>
<td colspan="2">Shirt Size?</td>
</tr>
<tr>
<td><input type="radio" name="size" value="Medium"></td>
<td>Medium</td>
</tr>
<tr>
<td><input type="radio" name="size" value="Large"></td>
<td>Large</td>
</tr>
<tr>
<td><input type="radio" name="size" value="X-Large"></td>
<td>X-Large</td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="submit" value="Register">
<input type="reset" value="Clear">
</td>
</tr>
</table>
</form>
</td>
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<p class="navtext">
<br>
<br>
<br>
<br>
Copyright © 2001 Grass Valley Group -
<a href="mailto:webmaster@grassvalleygroup.com?subject=Grass Valley Group website">webmaster@grassvalleygroup.com</a>
</p>
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