Technician Information Form

Please fill out the form below and we will be contacting you.

Please provide the following contact information:

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please identify and describe yourself:

Date of Birth

Sex Male Female

What equipment do you personally own? Select any of the following options that apply:

Oscilloscope                                      Real Time Analyzer                                
Computer Based RTA                                Mic Multiplexer                                 
Electronic Test Meter                             Laptop w/ Windows 95/98                           
Laptop w/ Windows 2000                            Laptop w/ Windows XP                            
Laptop w/ Other OS                                PSA Projection Screen Analyzer                    
Light Meter with readings in ft. L                Std Tools (wrenches, screwdrivers, allens, etc.)
Tachometer for Platter Timing                     Specialized Tools Not Listed

Please write a short paragraph to summarize your exprerience level and areas of expertise.
How many miles of travel do you feel is an acceptable distance to travel by car?
How many miles (round trip) are you willing to drive in one day?
At what distance of travel (one way) do you feel that a hotel is necessary to do your job?
If you have any comments about travel please list them here:
How would you rate your opinion of Dolby equipment?

bad poor average fair good
How would you rate your opinion of Ultra Stereo equipment?

bad poor average fair good
How would you rate your opinion of Smart Products?

bad poor average fair good
How would you rate your opinion of QSC Amps?

bad poor average fair good
How would you rate your opinion of BGW Amps?

bad poor average fair good
How would you rate your opinion of Component Engineering Equipment?

bad poor average fair good
How would you rate your opinion of Kelmar Equipment?

bad poor average fair good
How would you rate your opinion of Simplex Projectors?

bad poor average fair good
How would you rate your opinion of Century Projectors?

1 2 3 4 5
How would you rate your opinion of Christie Projectors?

bad poor average fair good
How would you rate your opinion of Cinemeccanica projectors?

bad poor average fair good
How would you rate your opinion of Strong lamphouses?

bad poor average fair good
How would you rate your opinion of Christie lamphouses?

bad poor average fair good
How would you rate your opinion of Strong platter systems?

bad poor average fair good
How would you rate your opinion of Christie platter systems?

bad poor average fair good
Please list any equipment that we did not ask opinions about above, but you feel is worth mentioning as being especially GOOD or BAD.
How would you rate your understanding AC power?

1 2 3 4 5
How would you rate your understanding of 'audio' electronics?

1 2 3 4 5
How would you rate your understanding of speakers and crossovers?

1 2 3 4 5
How would you rate your understanding of sound waves and room equalization?

1 2 3 4 5
How would you rate your understanding of projectors?

1 2 3 4 5
How would you rate your understanding of High Reactance Power Supplies?

1 2 3 4 5
How would you rate your understanding of Switching Power Supplies?

1 2 3 4 5
How would you rate your ability to troubleshoot?

bad poor average fair good
How would you rate your own MECHANICAL abilities?

bad poor average fair good
How many NEW screen installations have you been on where you where a major contributor or the only installer?
How many auditoriums have you been the installer for on a RETROFIT? This would include a complete removal and replacement of a sound system and/or projection system.
Would you be interested in selling equipment through RSEM to customers of yours and receiving a commission in return?

Yes No
Please add any other comments, notes about your experience, questions you may have, or other items in this area.

Date of Birth
Sex	Male Female

Technician Information Form

Copyright © 2003 R.S. Engineering & Mfg. All rights reserved. Revised: August 05, 2004

Copyright © 2003 R.S. Engineering & Mfg. All rights reserved.
Revised: August 05, 2004