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First Name:

Initial

Last Name:

Company Name:

Street Address:

City:

State/Province:

Postal/Zip Code:

Country:

Business Phone:

Ext.

Fax:

Web Site Address:

e-mail:


Please answer the following questions

Please indicate topics of interest to you: (check all that apply)

All Topics  
Direct promotions from Vendors Accessories
Promotions from Distributors Input Devices
Hot Deals/One-time offers Monitors
e-Commerce Solutions and Tools Web Publishing
Cool things on the internet USB
Hardware (General) Mobile Computing
Networking Printers
Multimedia Comdex After Show Feature
Home Computing Government
Servers Mass Storage/Backup
Software (General) Computer Security
Graphics & Publishing Communications
Education Entertainment
Remote Access Christmas Features
UPS Systems Back to School Features

Which best describes the type of business at this location?

Value Added Reseller
Computer Products Retailer (Storefront)
Systems Integrator/House
Software Retailer
Mass Merchandiser/Superstore
Internet Reseller
Mail-Order Reseller
Office Products Retailer(incl. Superstores)
Consultant
Other Computer Retailer(please specify)

Your Target Customers

Small Business % of total
Medium-Sized Business % of total
Large Business % of total
Consumer % of total
Education % of total
Government % of total
Other (please specify) % of total

Tell us about your location
Type of Location:
Storefront
Corporate Office
Corporate Office with Storefront
Number of Locations for your company:

Do you provide Service? Yes No

Which of the following Name Brand Computer System brands are you authorized to sell?

(Check all that apply)
IBM PC Series
IBM ThinkPads
IBM Aptiva Series
IBM Netfinity Servers
Compaq Desktops/Notebooks
Compaq Servers
Toshiba Notebooks
Hewlett Packard
NEC
Apple Macintosh
White Box (Generic, No Brand Name)
Other: (specify)

Which of the following categories do you resell, consult or integrate? (Hardware or Software)

(Check all that apply)
Windows 95/98
Windows NT/2000
Macintosh
Unix(Solaris/HP-UX, bsd, etc)
Linux
Novell
Networking/communications

Which best describes your job title?

Pres., Chrmn., Owner, VP, Dir., Gen., Mgr.
Purchasing Dir/Mgr./Spvsr. and Buyers
Branch/Store/Regional/District/Area Mgr.
Dept./Oprns./Service/Techn/Proj. Mgr., Assoc. and other Mgrs.
Sales/Mktg./Acct./Mgr.
Systems Spvsr/Integrator, Customer Serv. Spvsr./Mgr.
Chief/Proj./Dsgn/Syst/Applctns Eng., and other Engineering Titles
Product/Prod. Devpmt./Merchandising Mgr./Spvsr/Spclist
Sales/Mktg./Personnel
Consultant
Other (please specify)

What is your gross annual sales volume?
Under $500K
$500K to $2 million
Between $2 million and $5 million
Between $5 million and $15 million
Between $16 million and $100 million
Over $100 million

FOR AUDIT PURPOSES:

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Please give us the city you live in.

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