Please fill out this form to help us serve you better. *Required Fields Primary Business: Pick One Financial Real Estate Manufacturing Retail Wholesale Shipper Other *Name: *Company: *Phone: Fax: *Email: Website or Domain: Your Mailing Address: *Address: Address2: *City: *State: Alabama Alaska Arizona Arkansas California Colorado Conneticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana New Hampshire New Jersey New Mexico New York North Carolina North Dakota Nebraska Nevada Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tenessee Texas Utah Virginia Vermont Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick New Foundland Nova Scotia Ontario Prince Edward Island Provence Of Quebec Saskatchewan *Zip: *Country: # of PC's/ Workstations in Company: 1 User 2-5 Users 6-10 Users 11-15 Users 16-20 Users 21-25 Users 26-30 Users 31-35 Users 36-40 Users 41-45 Users 46-50 Users 50-60 Users 61-100 Users 100+ Users Are your PC's Networked? Pick One Yes No Don't Know Network Server Operating System Win2K Win98 Win95 NT XP No Server Current Contact Manager: Pick One ACT!2000 ACT! Outlook TeleMagic Maximizer GoldMine Dos GoldMine v2.5 GoldMine v4.0 GoldMine v5.0 Palm Organizer Other How did you hear about us? Pick One Search Engine Friend or Bus. Associate Newspaper Ad Magazine Ad Convention Brochure Need to make a decision by: Now 1-2 Weeks 2-4 Weeks 1 Month 2-3 Months 4-5 Months 6 Months - 1 Year 1+ Year Please be specific as possible.
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