Solution Center Visitor Registration Form By submitting this form, you hereby confirm that you have read and accepted the Personal Data Policy (“Personal Data Policy”) of Epson Malaysia Sdn Bhd (“Epson”), and you agree and consent that for the purposes of providing you with information on Epson’s products, relevant events and webinars and marketing and sales-related communications (if opted in and indicated above), responding to your queries, and such other purposes set out in our Personal Data Policy, Epson may collect, use, process, disclose and/or transfer any personal information and contact particulars submitted by you, in accordance with our Personal Data Policy. This may involve contacting you via email, phone call and such other communication platforms. You may withdraw your consent and unsubscribe at any time in accordance with our Personal Data Policy. The Personal Data Policy of Epson is available at: https://www.epson.com.my/personaldatapolicy.(Required)PDPA(Required) Yes No Consent Yes, I would like to opt in to receive marketing and sales-related communications regarding Epson products, services, and events. I can unsubscribe and opt out of receiving marketing and sales-related communications at any time.Visitor Type(Required)PartnerEnd UserPartner and End UserPurpose of Visit(Required)Product Demo/Integration testTrainingSeminar/WorkshopSolution Center Tour for GuestsTech UpdateOthersFirst Name(Required) Last Name(Required) Company(Required) Position(Required)CEO/CIO/CFO/COOBusiness OwnerProject ManagerIT ManagerPurchasing ManagerAdmin ManagerFinance ManagerMarketing /Sales ManagerAccount ManagerCS/Technical MangerEngineerOthersEmail(Required) Phone(Required)✓ Valid number ✕ Invalid numberIndustry(Required)Agriculture/Forestry/FishingArts/EntertainmentAutomotiveBanking/Financial ServicesBusiness Support ServicesConstructionDistributionEducationEnergy/UtilitiesEnvironmental ServicesFnB/RetailGovernment/Public SectorHealthcare/MedicalHousehold Economic ActivitiesManufacturingMining/QuarryingReal EstateTelecommunications/NetworkingTransportation/LogisticsSystem IntegrationOthersCompany Location(Required) Selangor, Johor, Sabah, PenangWhich Solution Center you visit?(Required)Solution Center SelangorSolution Center KuchingSolution Center PenangSolution Center JBI am interested in the following products(Required)Home/Office Printers - EcoTank SeriesBusiness Printers - EcoTank SeriesProfessional Photo Printer (A2/A3)Business Printers - WorkForce Pro (Cartridge)Business Printers - WorkForce Pro (RIPS)Business Printers - WorkForce Enterprise (LIJ)Business Printers - Technical Printers (T-series)Business Printer - Small Printer (POS)Business Printer - Dot MatrixBusiness Printer - Disc ProducerScanner - Document/Photo ScannersLabel Printers - Handheld label Printer (LW)Label Printers - Desktop Label Printer (CW)Large Format Printers - Signage Printer (Resin, Solvent, UV)Large Format Printers - Photo PrinterLarge Format Printers - MiniLab Photo PrinterLarge Format Printers - Direct-To-Garment Textile PrinterLarge Format Printers - Dye Sublimation Textile PrinterIndustrial Printers - Direct-to-Fabric Textile printerIndustrial Printers - Industrial Label PressesProjectors - HomeProjectors - High BrightnessProjectors - Corporate and EducationRobot - SCARA/6-AxisDo you have any specific requirements for this visit?Sales person / PartnerReferral Source(Required)Epson DealerSocial MediaAdvertisingWord of MouthExisting Epson CustomerOthersDemo PIC(Required) Sales Person / PartnerNotes(Required)Please state the product model