Connectivity Evaluation
*First Name
*Last Name
*Zip code
*Email Address
Network Administration Information
*Network Administrator
*Net Admin On Site?
*Net Admin Phone
*Net Admin Email
Current Network Environment
Printer Languages in use?
OS's you print from?
Current Network Protocols in use?
Current Print Server OS?
*Is PostScript Required for any applications?
*Is there a live network connection available and near the MFP?
*Is there an appropriate electrical outlet in place for the MFP?
Preferred Connection to our MFP?
MFP Configuration Information
Available IP Address for the MFP
Subnet Mask
Gateway Address
Primary DNS Server
Secondary DNS Server
Email Server
Name or Address
Preferred Scanning Method
Dedicated Fax Number (if applicable)
format: (559) 123-4567
Is a live phone jack available for the fax option?
*Required Field
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