First Name: *    
Last Name: *    
Title/Position: *    
Company: *    
Location: *    
Email Address: *    
Phone Number: *    
Shifts Per Day: * -Select- 1 2 3    
Approximate facility size (sq. feet): *    

	Class 1 Sit-down Counterbalanced Truck	Class 2 Reach Truck	Class 3 Rider Pallet Truck
Batteries Per Truck
Battery Change Personnel Per Shift
Hours Per Shift
Lift Truck Operating Hours Per Year
Number of Operational Days Per Year
Trucks Operating Per Shift