Customer Inquiry Form
Please completely fill out the request form below
, or send an e-mail to
sales@brilliancorp.com
for additional information.
GENERAL INFORMATION
First Name
Last Name
Job Title
Company
Address 1
Address 2
City/State/Zip
/
/
Country
Phone
E-mail
Fax
HDTV PRODUCT INTERESTS
(check all that apply)
Brillian 6501mPB 65-inch 720p HDTV
Brillian 6501mFB 65-inch 720p HDTV
Brillian 6580iFB 65-inch 1080p HDTV
PROJECTION PRODUCT INTERESTS
(check all that apply)
Brillian BR768HC Microdisplay
Brillian BR1280 Microdisplay
Brillian BR1920 Microdisplay
Brillian Projection Development Kit
Projection Engines/Reference Designs
NEAR-TO-EYE PRODUCT INTERESTS
(check all that apply)
Brillian Z86D-3 Microdisplay
Brillian Z86D-3 Development Kit
OTHER PRODUCTS
(please specify)
HOW DID YOU HEAR ABOUT BRILLIAN?
(complete all that apply)
Advertisement
Trade Show
Search Engine
Other
COMMENTS/QUESTIONS
