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*  First Name
*  Last Name
*  Title
*  Company
*  Address
*  City
*  State
Country
*  Zip
*  Phone
Ext
Fax
*  Email
Web


*  Which category best describes your business?
Dealer/Reseller
Independent Retailer
Office Superstore
Chain/Department/Discount store
Internet Retailer
Wholesaler/Distributor
Manufacturer
Manufacturer’s Representative
Other


*  What of the following best describes your job function?
President/Partner/Owner/Principal
Operations Management
Buyer/Purchasing Agent
General Manager
Sales/Marketing
Account Representative
Technician
Service Manager
Other


Average annual revenue of your company:
Under $1 million
$1-$4.9 million
$5-$9.9 million
$10-$49.9 million
$50-$99.9 million
$100 million+


How many people are employed in your organization?
1-10
11-20
21-50
51-100
101-250
More than 250


Types of products/services provided (check all that apply):
Printers
Wide-format printers
Copiers
Facsimile machines
Duplicators
Computer Hardware
Computer Software
Wireless Networking
Document Management Software
Document Scanning Equipment
Workflow Management Software
Business Applications (email, messaging,CRM)
Storage & Server Solutions
Infrastructure
Digital Convergence
Mobile & Wireless Technology
Networking & Systems Management
Security
Re-manufactured equipment
Re-manufactured supplies
Supplies, Parts & Accessories
Service & Repair
Installation
Other


*  Lines carried or represented (check all that apply).
Brother
Canon
Copystar
Epson
Gestetner
Hewlett Packard
Konica-Minolta
Kyocera-Mita
Lexmark
Muratec
Oki Data
Panasonic
Ricoh
Samsung
Sharp
Toshiba
Xerox
Other-1
Other-2
Other-3
Other-4


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