Network Requirements

This form must be completed before installation of any copiers, printers or scanners.
Please fill out the form below, or click here to download a PDF form.

* Required Fields
Customer: *
Email Address: *
Model: *
Sales Rep.:

What type of connection? Network    USB    Parallel    Other

What type of system and service pack? Windows 7    Vista    XP    MAC (Version )    Other

Service Pack     Server Version

Where are print drivers loaded? Server    Local Computer

Network Administrator / Network Contact Person:

Please complete the following if you are using a Network connection:
IP Address (static) (if needed)
Subnet Address
Gateway Address
DNS (primary/secondary)
Server Name or Address
Fax Number

SMTP Server Address (email provider)
Authentication User NamePassword
Local PC or Server (shared drive or user folders)

Any one-touch or pre-programmed emails or
fax numbers from existing machine that need
setup in new equipment?
Yes    No     How Many?

Any equipment to move or remove? Yes    No

Please provide all necessary cables to connect your copier, printer or scanners. If needed, Quality can provide them at an additional charge.

Verification Code:*
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2192 Embassy Drive
Lancaster, PA 17603
Local: (717) 293-1950
Toll Free: (866) 228-4400
Wyomissing, PA 19610
Local: (610) 898-0726
Toll Free: (866) 228-4400
Harrisburg/Lewistown/State College:
119 Aster Drive, Suite 104
Harrisburg, PA 17112
Local: (717) 564-7011
Toll Free: (866) 228-4400
Monday-Friday: 8:00am-5:00pm