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Required 1.

Please enter the information indicated below. (required)
First Name:
Last Name:
Company Name:
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Email Address:
emailaddress@xyz.com
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2.

Do you specify Surge Suppression Incorporated (SSI) products?
Yes, SSI is listed by part number.
SSI is listed in my Guideform Spec.
We use Master Spec., CSI or other standard spec. writing company
No
3.

Does your present specification comply with the new ANSI/UL 1449-2006 (aka "Third Edition") Standard?
Yes
No
Not sure
4.

May we assist with updating your current specification to meet the UL "Third Edition" requirements?
Yes - please contact me. (Indicate preferred means of contact in box below.)
No
Not applicable
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5.

Would you or your firm be interested in SSI's Lunch & Learn Presentation?
Yes - please contact me. (Indicate preferred means of contact in the box below.)
Possibly - I've attended in the past.
My associates may be interested (Provide names and email addresses in box below.)
No, not at this time.
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6.

Would you be interested in attending or hosting an IEEE Continuing Education Seminar in your area that will allow attendees to earn CEU/PDH?
Yes, please contact me.
I've attended in the past and would like to again.
My associates may be interested. (Provide names and email addresses in the box below.)
No, not at this time.
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