Information Request Form

Fields marked with a * are required. First Name*: Last Name*: Company*: Address*: City*: State*: Zip code*: Country: Telephone*: Fax: E-mail*:   What is your title?* Chairman/President/CEO/COO CIO/CTO/CFO/EVP/SVP Vice President/General Mgr Director/Manager Software Design/Programmer Webmaster/Web Designer Analyst Other What is your function?* Corporate Management Electronic Commerce Marketing/Sales Information Technology/MIS Purchasing/Operations/Traffic Customer Service Finance Administration Consultant Other Which best describes your industry?* Aerospace Automotive Chemical Consumer Products Financial Services High Tech/Electronics Retail Telecommunications Equipment Consultant Other Manufacturing What is your company's approximate annual revenue? Under $250M $250 - $500M $500M - $1B $1B - $3B $3B - $5B $5B - $10B More than $10B Does your organization currently sell products over the Web? Yes No How much did you, or do you plan on spending on your Web-based e-commerce solution? Less than $250,000 $250,000 - $500,000 $500,000 - $1 million $1 million - $3 million more than $3 million Don't Know If you do not have Web-based ordering today, what is your time frame for implementing it? 0-3 months 4-6 months 6-12 months over 12 months How did you hear about SpaceWorks?* Analyst Direct Mail E-Mail News Article Referral Press Release Tradeshow Web Other
I would like you to please:	send me an information package send me a free self-running OrderManager demo diskette call me to schedule an on-site demonstration