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  1. First name*
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  2. Last name*
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  3. Gender*
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  4. Company*
    Please enter your Company name, if not applicable write “N/A”
  5. Country*
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  6. If you are located outside of Greater Europe, please visit the corporate headquarters at: www.dino-lite.com
  7. Telephone number
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  8. Email*
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  9. Dino-Lite Model*
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  10. Serial number (s/n)
    Please enter your Dino-Lite serial number which can be found on the service tag attached to the USB cable.
  11. Software Version*
    Please enter the Dino-Lite software being used!
  12. Operating System*
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  13. Purchased from
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  14. Problem description*
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