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First Name:
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For audit validation purposes, on which day of the month were you born?

1. Do you purchase, approve, or recommend the purchase of information technology products and services? (Check Only One)
Yes No

2. How many people are employed in your entire organization?
(Check Only One)
20,000+
10,000 - 19,999
5,000 - 9,999
1,000 - 4,999
500 - 999
100 - 499
Less than 100

2A. What is your total company revenue?
(Check Only One)
1 Billion +
400-999 Million
100-399 Million
50-99 Million
10-49 Million
< 10 Million

3. What is your primary job function?: (Check Only One)
CIO / CTO / VP of IS / MIS
Manager / Director of IS / MIS / DP (Systems/Technical Services)
VP / Manager / Director of Networking / Database Admin / Analyst / Internet Services
VP / Manager / Director of Engineering / Manufacturing
Other Computer-Related
Executive (CEO / COO / Pres. / Partner / Owner / GM)
Financial / Accounting (CFO / Controller)
VP / Manager / Director of Operations / Administration / HR
VP / Manager / Director of Sales / Marketing / Customer Service / Business Development
Consulting Services
Inventory / Purchasing / Logistics / Warehouse / Transportation / Plant Management
Project / Program / Product Management
Field Service / Sales Management
Other Departmental Management
Other Professionals

4. What is your organization's primary business activity? (Check Only One)
Discrete Manufacturing (including aerospace and automotive)
CPG / Process Manufacturing
Computer Manufacturers (hardware, software, peripherals)
Computer-Related Retail / Wholesale / Distribution
Wholesale / Distribution (non-computer)
Retail / Hospitality
Healthcare / Pharmaceutical / Medical / Dental
Finance / Accounting / Banking
Insurance / Real Estate / Legal
Government - Federal/State/Local
Public Safety / Security
Military
Communications (Cable / Internet / Telecom / Broadband)
Transportation / Logistics
Utilities / Energy / Mining
Construction / Architecture / Engineering
Data Processing Services
Education
Media / Publishing / PR / Marketing / Advertising
Business Services / Consultant (non-computer)
Computer / Network Consultants / VAR / VAD / ISV / Systems Integrator
Service Industries / Non-Profit / Associations
Other Qualified Business

5. What are your technology interests? (Check All That Apply)
ERP / MRP / WMS
Content Management / Records Management / Imaging
Supply Chain Management
AIDC (Bar coding)
Asset Tracking / RTLS
Remote Management/Diagnostics
Customer Relationship Management (CRM)
Field Service / Sales
Wireless / Mobile Computing
Wireless Networking
RFID
VoIP / Convergence
Fleet Management

6. What products / services is your organization utilizing, implementing, or investigating for future use? (Check All That Apply)
A. SOFTWARE
Web Content Management
Customer Relationship Management / Marketing (CRM)
Enterprise Resource Management (ERP)
Supply Chain Management (SCM)
Warehouse Management Systems (WMS)
Workflow / BPM
Records Management
Email Management
Call Center / Help Desk
Imaging / Document Management
Forms Processing/Data Capture
Content Management
Transportation Management Systems (TMS) / Fleet
Logistics
Bar Code Labeling Software
Groupware / E-Mail
Network Operating Systems
Mobile Workforce Management
Field Service
RFID Middleware
Sales Force Automation
GPS / LBS / GIS
Route Accounting / Direct Store Delivery / POD
Remote Management / Diagnostics

B. HARDWARE
Enterprise Servers
Virtual Private Networks
LANs / WANs
Wireless Networks / Mobile Computing
VoIP
Printers
High-Speed Production Scanners
Desktop / Workgroup Scanners
Smart Phones
Tablet / Laptop Computers
Bar Code Printers
Bar Code Scanners
Hand Held Computers / PDAs / 2-Way Radio
RFID Tags (active/passive)
RFID Readers
Preprinted Labels
Mobile Printers / Scanners

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