The following information is needed to set up your EPIC Track accounts. This is required to process your order correctly.
Reseller Contact Name:
Reseller Contact Phone:
Reseller Contact Email:
Account Name (End User Account)
Account Owner Name (End User who Administers System)
Address (End User Address)
Phone (End User Phone)
Email (End User Email)
Optional If Elliott Data will be leading the set up Epic Connector, and or handling training, the follow info is
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