COCHRAN
UNDERSEA TECHNOLOGY
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Gemini Trade In Form
Form filled out by:
  Employee Name Dealer #
Dealer
Consumer
Both  Dealer, please complete the information above
Personal Information
First Name Last/Sur Name
Address
City State/Province Zip/Postal Code Country
Home Phone FAX Mobile/Work
E-Mail
Certification Agency Certification Type Certification Number
Comments (Preferred Dealer, etc.)
Where did you purchase your dive computer?
Store Name
City State/Province Country
Dealer # Contact Name
Phone FAX
E-Mail
Type of computer being traded in?
Date of purchase Amount Paid for computer Serial #
Do you currently use our Analyst software? If yes, what version?
Yes No
Gemini Selection
Mounting
Computer Price
Analyst Price
Total
Case Color
TacLite
Blends
Wrist Unit
Cable Length
Memory Size
Units
Analyst