Warranty Card Submission Form

Serial# *

Enter your serial number

'); modelcount++; $('.model-dropdown').change(function(){ var id = $(this).attr('id'); if($(this).val() == 'Other'){ $('#'+id+'other-box').html('Other Model Name *

Enter your \'other\' model

'); } else{ $('#'+id+'other-box').html(''); } }); } else{ alert('There is a maximum of 10 warranty items per form.'); } }); $(function() { $( "#pur_date" ).datepicker(); }); $('.model-dropdown').change(function(){ var id = $(this).attr('id'); if($(this).val() == 'Other'){ $('#'+id+'other-box').html('Other Model Name *

Enter your \'other\' model

'); } else{ $('#'+id+'other-box').html(''); } }); });

Company name *

Enter your company name
Contact name/position *

Enter your contact name
Email *

Enter a valid email address
Street *

Enter your street
City *

Enter your city
State / Province *

Enter your state/province
Zip *

Enter your zip
Country *

Enter your country
Telephone *

Enter your phone number

Model *
Serial# *

Enter your serial number

+ Add Model Field
Purchased From

Enter where you purchased
Purchase Date *

Enter your purchase date
Distributor/Sales name *

Enter your distributor/sales contact name
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