Extended Warranty Registration Form

First & Last Name*

Company Name

Email Address*

Phone Number*

Warranty Code On Product*

for multiple products please put a forward slash (/) between each warranty code

Choose Your Market Sector*
---RailwaysMODSecurityEmergency ServicesUtility CompaniesHighways AgencyEnvironmental AgenciesAgriculturalSport & Leisure

Choose Your Products*
ECO-FLOOD 14K6ECO-FLOOD SPORTALU2000/4000LiALU4000LiALU2000LiSL2000LiSL850LiFSL850LiSHL600FHL3000WHL1300WHL600WULTRALIGHT LEDULTRALIGHT 1500ULTRALIGHT 3000HD200 LEDHD200 1500HD200 3000ULTIMATE KITMAGNAFLASH

Where did you purchase your Samalite Product?*

Invoice Number

this field is not required for Network Rail

Date of Purchase*

Address Line 1*

If purchased through a company, please fill in company’s address details below

Address Line 2 (Optional)

Town*

County*

Postcode*

Country*