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<HTML>

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<META NAME="description" CONTENT="GB Industrial Battery and Charger, Batteries and Chargers for Forklift Applications.">
<META NAME="Keywords"    CONTENT="forklift battery,forklift batteries,industrial batteries,industrial battery,fork lift batteries,fork lift battery,forklift,fork lift,industrial,charger,chargers,exide,general,gbc,enersys,gnb,hawker,bulldog,c-d,c&d,deka">


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<TITLE>Warranty Registration:                                                          For GB products that were not purchased directly from GB Industrial Battery.</TITLE></head>
<BODY  BGCOLOR="#FFFFFF"
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LEFTMARGIN="0" TOPMARGIN="0" RIGHTMARGIN="0" BOTTOMMARGIN="0"

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      <!-- BOF: ./personal-templates/simple/business/layout/l59.layout -->

 
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<TABLE WIDTH="100%" height="100%" BORDER=0 CELLPADDING=0 CELLSPACING=0 align="center" valign="top" background="widgets/gen_1056.1.gif" bgcolor="#78A156">
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                             <!-- BOF: ./personal-templates/simple/businessnew/form/style_l59.html -->
<TABLE WIDTH=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
<TR>
    <TD WIDTH=100% COLSPAN="2" VALIGN="top">
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<SCRIPT LANGUAGE="JavaScript">
var BUILDER = '/studio/servlet/psoft.masonry.Builder';
function validate(frm){
var i = 0;

if (frm.field_124.value=="") return error(frm.field_124);

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function error(field){ alert('You did not fill all required fields!'); field.focus(); return false; }
</SCRIPT>
<form name="questionary" action="http://216.14.208.12:8080/studio/servlet/psoft.customform.CustomForm" method="post">
<input type="hidden" name="domain" value="">
<input type="hidden" name="title" value="Warranty Registration:                                                          For GB products that were not purchased directly from GB Industrial Battery.">
<input type="hidden" name="esubj" value="Warranty Registration">
<input type="hidden" name="name" value="=GCh0WG0bU1bal4b">
<input type="hidden" name="submit_url" value="onsubmit4.html">
<input type="hidden" name="error_url" value="onerror4.html">

<input type="hidden" name="order" value="116 d117 118 119 120 121 122 123 124 ">

        <TD VALIGN="top">
        
<TABLE WIDTH=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
                                 <TR>
                                    <TD WIDTH=6 HEIGHT=7>
                                        <img src="widgets/gen_1085.1.gif" border=0 width=6 height=7 alt=""></TD>
                                    <TD background="widgets/gen_1084.1.gif">
                                        <img src="widgets/spacer.gif" height=1 width=7 alt=""></TD>
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                                    <TD background="widgets/gen_1088.1.gif">
                                        <img src="widgets/spacer.gif" height=5 width=6 alt=""></TD>
                                    <TD WIDTH=100% VALIGN="top" BGCOLOR="#E2F8D1" VALIGN="top" style='border-bottom: 1px dotted #78A156'>

         <span style="color:#385D1A;font-size:12px;font-weight:bold;font-family:Verdana,Arial,Helvetica">Warranty Registration:                                                          For GB products that were not purchased directly from GB Industrial Battery.</span>
         </TD>
         <TD background="widgets/gen_1087.1.gif"><img src="widgets/spacer.gif" height=5 width=5 alt=""></TD>
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         <TR>
                <TD background="widgets/gen_1089.1.gif"><img src="widgets/spacer.gif" height=1 width=6 alt=""></TD>
                <TD WIDTH=100% VALIGN="top" BGCOLOR="#FFFFFF" VALIGN="top">

        <TABLE border="0" cellpadding="5" cellspacing="5" width="100%">
        <input type="hidden" name="name_116" value="Product Serial Number:">
        <TR><TD>


<font face='Arial' size='2' color='#333333'>

Product Serial Number:

</font>


</td>
            <TD><input type="text" name="field_116" size=35 style="background: #F3FBED;border:1px solid #78A156">
            
            </TD>
        </TR>
        <input type="hidden" name="name_117" value="Purchase Date (approximate):">
        <TR><TD>


<font face='Arial' size='2' color='#333333'>

Purchase Date (approximate):

</font>


</td>
            <TD><select name="field_m_117" size="1" style="background: #F3FBED;border:1px solid #78A156">
            <option>Jan<option>Feb<option>Mar
            <option>Apr<option>May<option>Jun
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<font face='Arial' size='2' color='#333333'>

Purchased from:

</font>


</td>
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            </TD>
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<font face='Arial' size='2' color='#333333'>

Purchased as NEW?:

</font>


</td>
            <TD><input type="radio" name="field_119" value="Yes">


<font face='Arial' size='2' color='#333333'>

Yes

</font>


 <input type="radio" name="field_119" value="No">


<font face='Arial' size='2' color='#333333'>

No

</font>


            </TD>
        </TR>
        <input type="hidden" name="name_120" value="Your Company Name:">
        <TR><TD>


<font face='Arial' size='2' color='#333333'>

Your Company Name:

</font>


</td>
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            </TD>
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        <input type="hidden" name="name_121" value="City and State where product will be used:">
        <TR><TD>


<font face='Arial' size='2' color='#333333'>

City and State where product will be used:

</font>


</td>
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<font face='Arial' size='2' color='#333333'>

Contact Name:

</font>


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            </TD>
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        <input type="hidden" name="name_123" value="Phone Number:">
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<font face='Arial' size='2' color='#333333'>

Phone Number:

</font>


</td>
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            </TD>
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        <input type="hidden" name="name_124" value="Email Address:">
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<font face='Arial' size='2' color='#333333'>

Email Address:

</font>


<font color="red" size="-1">*</font></td>
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        <TR><TD colspan=2 align=center><input onClick="return validate(form)" type="submit" value="Register" style="background: #E2F8D1;border:1px solid #78A156">
            <input type="reset"  value="Reset" style="background: #E2F8D1;border:1px solid #78A156"></TD>
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                                    <TD background="widgets/gen_1090.1.gif">
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</form>
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    </TD>
</TR>
</TABLE>
<!-- EOF: ./personal-templates/simple/businessnew/form/style_l59.html -->

                                </td>
                             <td height="100%" width="11" background="widgets/gen_1055.1.gif" align="right"><img src="widgets/spacer.gif" height=1 width=11 alt=""></td>
                          </tr>
                          <tr>
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                 <td width="100%" colspan="2">
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                             <td background="widgets/gen_1047.1.gif" width="100%"></td>
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                             <TD bgcolor="#BBD9A3">
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">
<a href="gbindustrialbattery.com"></a>
<br>
<font face="helvetica,verdana, arial" size="1">Copyright: GB Industrial Battery, USA</font>

</td></tr></table></center>


<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">GB - Home</A>|</nobr>

<nobr>|<a href="gpage1.html">How to Order</A>|</nobr>

<nobr>|<a href="Request.Quote.html">Request Quote - BATTERY</A>|</nobr>

<nobr>|<a href="form.html">Request Quote - CHARGER</A>|</nobr>

<nobr>|<a href="form1.html">Order Form - BATTERY</A>|</nobr>

<nobr>|<a href="external1.html">Battery Sizes and Specs.</A>|</nobr>

<nobr>|<a href="form3.html">Credit Application - Online</A>|</nobr>

<nobr>|<a href="external2.html">Credit Application - Printable</A>|</nobr>

<nobr>|Warranty Registration|</nobr>

<nobr>|<a href="gpage.html">Instructions - Online Forms</A>|</nobr>

<nobr>|<a href="contact.html">Suggestions</A>|</nobr>
</center>
</font>

</td>
                             <td background="widgets/gen_1050.1.gif"><img src="widgets/spacer.gif" height=1 width=1 alt=""></td>
                          </tr>
                          <tr>
                             <td><img src="widgets/gen_1043.1.gif" border=0 width=11 height=15 alt=""></td>
                             <td background="widgets/gen_1048.1.gif" width="100%"></td>
                             <td><img src="widgets/gen_1044.1.gif" border=0 width=16 height=15 alt=""></td>
                          </tr>
                      </table>
                 </td>
              </tr>
            </TABLE>
       </TD>
    </TR>
</TABLE>
<!-- End html -->
<!-- EOF: ./personal-templates/simple/business/layout/l59.layout -->

    
<!-- BOF: ./personal-templates/simple/themes.show.body -->


<!-- EOF: ./personal-templates/simple/themes.show.body -->

</body>
<!-- BOF: ./personal-templates/simple/themes.show.end -->


<!-- EOF: ./personal-templates/simple/themes.show.end -->


</html>


<!-- EOF: ./personal-templates/show.body -->