Fields marked with an asterisk * are required
First Name* : Company*: Phone*:
Last Name*: E-mail*:
What industrial vertical(s) are you in? (Select all that apply.)*
Aerospace: Alternative Energy
Health & Wellness Other (Describe):
Where do you wish to grow your market? (Select all that apply.)
Asia Europe North America
South America Other (Describe):
Do you have a physical sales presence in these regions now? Yes No
Do you have a plan for physical sales presence in these regions? Yes No
Do you currently export to these regions? Yes No
Do you wish to market new products or intellectual property on your new web site? Yes No
Describe your customers by occupation. (Select all that apply.)
Executive Finance Tehcnical
Procurement/Buyer Other (Describe)
What is the status of your *Web project?
Feasibility Planning Budget Approved Other (Describe Below)
When do you wish to launch your Internet solution This Quarter Within the year
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