Test Drive Request
Distributor Information
Distributor Name
*
-- Select --
ACI Machine Tool Sales LLC
Alta Enterprises, Inc.
Applied Machine Solutions Inc.
Brooks Associates, Inc.
CJ Smith Machinery Company
Clinton Wenzel Machine
Concept Machine Tool
COSA Intermaquinas
Dynamic Machine PA
Elliott-Matsuura
Excel Machine Technologies
Humston Machinery, Inc.
Hurco Direct
Integra (LG Evans)
Ironwood
Machine Tech
Machinery Sales Company (MASCO)
Macias
Mayprod, Central America
Merrifield Machinery Solutions
Mid Atlantic Machinery
New Vision Machine Tools
Prosper Machine Tools
PTSolutions
Reynolds Machinery, Inc.
Rosco Precision Machinery, LLC
Stone Machinery, Inc.
Takumi USA Direct
TECNOMAQUINARIA
Zenith Machine Tools
Distributor Salesperson Name
*
Distributor Salesperson Email
*
Was the Test Drive request approved by a Distributor Principal?
*
-- Select --
Yes
No
Customer has work required to justify purchase?
*
-- Select --
Yes
No
Customer has financial wherewithal to purchase after 60 days
*
-- Select --
Yes
No
Customer has interest in a Hurco Test Drive?
*
-- Select --
Yes
No
Customer already has a Hurco or Takumi machine?
*
-- Select --
Yes
No
Customer Information
Name of Facility (i.e. Bob's Machine Shop)
*
Physical Address (Street)
City
*
State/Province
*
ZIP/Postal Code
*
Country
Company Name
*
Contact Name
*
Title
Email
*
Phone Number
Machine Information
Machine/Product Type
*
-- Select --
Hurco
Takumi
Procobots
Machine Model for Test Drive
*
Is the machine in-stock?
*
-- Select --
Yes
No
Existing Customer Machine
Frame Number
Options/Accessories Required
*
Current Machines Make & Models
*
Reason for Test Drive
*
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