Reynolds and Reynolds
POWER Workstation Order Form

Customer Information
Client Number:  
Dealership Name:  
Contact Name:  
Phone Number:   
Fax Number:   
Email Address:   
(Your Confirmation will be sent to this address)
*Please list the fax number for the person at the dealership that will execute the
Contract Amendment, and their name (if different from the Contact Name above).

POWER Workstation
  POWER Workstation should be requested by location. Please specify, by entering the
quantity in the appropriate spaces provided below, if any of the Total POWER
Workstations(s) you are requesting are for use with a POWER erver or on CPD 2000Net
Equipment (leave these fields blank if you are not 100% certain)

Total POWER Workstation(s) Requested (Qty) POWER Server? (Qty) CPD 2000Net? (Qty) Branch Number Branch Name
Enter the code from the image: