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EDM Triple Diamond Members Area Registration Form |
 MC Machinery Systems, Inc.
1500 Michael Drive • Wood Dale, IL 60191
PHONE: (630) 616-5900 • FAX: (630) 860-9816
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| Please take the time to become a registered member of the MC Machinery Systems website. Registration gives you the ability to access all areas of our site so that you can take full advantage of our services and solutions. Please print and complete the form. Once completed, fax to 630-860-9816 ATTN: Customer Service Administration. Once approved, a Login ID with your password will be e-mailed to you. |
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Personal Information
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| Title: |
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Your Name: |
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Phone Number:
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Fax Number: |
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| E-mail Address: |
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User provided password:
(min. of 6 characters) |
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Workplace-Related Information
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| Company: |
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| Department: |
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| Street Address: |
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| Address (cont'd.): |
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| City: |
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| State / Province: |
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| Zip / Postal Code: |
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| Country: |
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EDM Contract Selection
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| Contract Description |
Term |
Price |
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Technical Support GOLD Package |
1-year |
$900.00/Site |
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Technical Support PLATINUM Package |
1-year |
$1,500.00/Site |
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Extended Warranty GOLD Package |
1-year |
$4,500.00/Machine |
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Extended Warranty PLATINUM Package |
1-year |
$4,990.00/Machine |
| Method of Payment |
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Check |
(Please include check with application) |
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Purchase Order |
(Please include hard copy with application) |
User acknowledges that by accessing the System User will be given access to proprietary and confidential information. All information accessed via the System must be kept strictly confidential and protected from disclosure with the same degree of care as User treats its most confidential information, but with no less than a reasonable degree of care. The System may only be accessed, and the information provided on the System may only be used, by the User for the diagnosis and repair of equipment owned and used by User in User's own business. User agrees to safeguard User's username and password. Usernames and passwords may only be disclosed to individuals that have signed a copy of this Agreement during user’s employment. In the event a password has been lost or compromised, User must inform MC Machinery immediately so that it may be deactivated and replaced. In the event the user becomes terminated from employment, the user’s supervisor will notify MC Machinery immediately so that user’ s password can be deactivated.
Although MC Machinery endeavors to make the information found on the System accurate and accessible to authorized Users, MC Machinery does not guarantee the accuracy, usefulness, or accessibility of the System or the information made available through the System. Use of the System and the information obtained through the System is on as "AS IS" and "AS AVAILABLE" basis, and MC Machinery makes NO REPRESENTATIONS OR WARRANTIES of any kind INCLUDING BUT NOT LIMITED TO MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. |
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Applicant's Signature:
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Supervisor/Manager Name (Printed):
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Supervisor / Manager (Signature):
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Date:
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Information 
