Turbine Request Work Order

XZERES Corporation Turbine Request Form
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Product Information

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Enter the Serial number of the System

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Enter a Name for the Turbine in case you have multiple turbines.

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System Site Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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When was your Turbine installed.

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Dealer Information

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Dealer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Owner Information

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Owner/Contact Name

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(If owned by Company)

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Owner Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Turbine Request Information

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Attach any files that might be important for your Warranty claim.

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Turbine Request Work Order

Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Product Information

System Serial Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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System Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Wind Turbine Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Product Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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System Site Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Tower Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Tower Height {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Commissioning Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Product Status {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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XZERES Gateway ID Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Dealer Information

Dealer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Dealer EMail {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Dealer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Dealer Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Dealer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Owner Information

Owner Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Owner Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Owner EMail {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Owner Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Turbine Request Information

Claim Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Upload Pictures/Videos {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
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Turbine Request Work Order

XZERES Corporation Turbine Request Form
Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Product Information

System Serial Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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System Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Wind Turbine Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Product Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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System Site Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Tower Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Tower Height {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Commissioning Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Product Status {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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XZERES Gateway ID Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Dealer Information

Dealer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Dealer EMail {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Dealer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Dealer Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Dealer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Owner Information

Owner Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Owner Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Owner EMail {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Owner Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

Turbine Request Information

Claim Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Upload Pictures/Videos {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
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Cognito Forms{{ Cognito.resources["powered-by-cognito"] }}