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Customer Registration

To register your interest with a view to purchase, and to receive a Centaur 2 brochure, please complete the following:

Your contact details

Name:			Tel 1:
(Company):			Tel 2:
(Title):			Fax:
Address:			Email:
City:
State/County:
Zipcode/postcode:
Country:
If you are a newcomer, please advise how or through whom you were introduced to this website:

Your own interests and operations Please help us to understand you and your operations.
Nature of interest in aviation or marine industry:

Type(s) of aircraft, helicopter or boat that you or your company operate:
	Type	Quantity
1		1 2 3-5 6+
2		1 2 3-5 6+
3		1 2 3-5 6+
4		1 2 3-5 6+

Are these owned by you? Yes No ...or hired/leased by you? Yes No
Any comment on your operation would be appreciated........
What are your flying aspirations or objectives?
Any factors that particularly inhibit your operation?
Any particular issues that you would like more information on?

I would like to discuss purchase-option opportunities.	Yes No
I would like to discuss financial opportunities.	Yes No

Any other comment or correspondence

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