Washington Technology FREE Subscription Form

First Name:        Last Name:         Title:             Company Name:      Address1:          Address2:          City:              State:             ZIP Code:          Country:           Office Phone:      (format: 123-456-7890) Office Fax:        (format: 123-456-7890) Business E-mail:   

1. I wish to receive/continue to receive a FREE subscription to Washington Technology:
Yes No

2. Does your company provide systems integration products or services to the following types of business (select all that apply):

	As a:
Provided to :	Prime Contractor	Sub- Contractor	8A/Minority Disadvantaged	Other
1. Federal Government
2. State & Local Government
3. Commercial Business
4. International
If Other, please specify:

3. The primary business activity of your organization is (select one only):

1. Systems Integration 2. Network Integration 3. VAR -Systems Integration 4. VAR - Vertical Application 5. Systems/Software Development 6. Systems/Software Consultant 7. OEM - Manufacturer Integration 8. Distributor/Aggregator 9. Communications Integration 10. Aerospace/Defense Integration 20. Federal Government Executive 21. State or Local Government Executive 99. Other

If Other, please specify:

4. Please indicate your primary job function (select one only):

1. President/CEO 2. Program/Project Management 3. Technical Management 4. General Corporate Management 5. Business Development 6. Marketing Management 7. Sales Management 8. Engineering 9. Systems Analyst 10. Contract Management/Officer 99. Other

If Other, please specify:

5. Please indicate the products and services which you or your organization resells, specifies, recommends or approves the purchase of (select all that apply):

COMPUTER SYSTEMS

6.Please indicate the value of products and services that you resell, specify, recommend or approve the purchases of (select only one):

$25 million or more Over $10 million to $25 million Over $5 million to $10 million Over $1 million to $5 million Over $500,000 to $1 million Over $100,000 to $500,000 Over $25,000 to $100,000 Under $25,000

7.Please indicate the largest company/federal agency that you automate (select only one):

Over 10,000 employees 5,000 to 9,999 employees 1,000 to 4,999 employees 500 to 999 employees 100 to 499 employees Under 100 employees

8. My organization can purchase off the GSA schedule:

Yes No

9. My organization is involved in teaming decisions with other contractors:

Yes No

10. We would normally ask that you sign the subscription application form. But since we're online, we ask that you provide a personal identifier. We recommend that the personal identifier be the state or foreign country in which you were born.