Xilinx Evaluation Registration ID Request

Instructions: 1. Please print this form and complete the following information. 2. Please provide accurate information. 3. Fields marked with an asterisk (*) are required. 4. FAX completed form to 720-652-3444 (USA) 5. Your Xilinx Evaluation Registration ID, which is required for product installation, will be sent to the fax number you provide below. *First Name: *Last Name: Title: *Company:
Note Xilinx is unable to deliver software to a post office box. Please specify a delivery address that does not contain a post office box.

*Address1: Address2: Address3: *City: *State/Province: *Post/Zip: *Country: *Phone: *Fax: E-mail: *Product ID:
Note Your Product ID number is located on the back of your software packaging.

You will receive an e-mail from Xilinx with your software registration information within 48-hours of sending this FAX, if you have provided an e-mail address. If you have not provided an e-mail address, you will receive a FAX from Xilinx with your software registration information. For further assistance, please contact Xilinx at the above FAX number.