Washington Technology FREE Subscription Form

• Aug 29, 1997

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

Select only one
SYSTEMS INTEGRATORS 1. Systems Integration 2. Network Integration 3. VAR (Value Added Reseller) 4. Systems/Software Development 5. Systems/Software Consultant 6. OEM - Manufacturer Integration 7. Distributor/Aggregator 8. Communications Integration 9. Aerospace/Defense Integration

GOVERNMENT EXECUTIVE 11. Federal Government Executive 12. State or Local (county/municipal)

Other Industries
Please Specify:

3. 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:

4. My computer provides systems integration products or services to: (select all that apply)

Federal Government
State/Local Government
Commercial business
International business

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

		Washington Technology FREE Print Subscription Form Washington Technology delivers strategic business information to systems integrators, prime contractors and subcontractors that are active in the government marketplace. Qualification for free print subscriptions determined by publishers. Incomplete forms will not be processed. I wish to receive/continue to receive a FREE subscription to Washington Technology: Yes No 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. 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 Business
If Other, please specify:

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.

Thank you for taking the time to fill out our questionnaire. Qualification for free subscriptions is determined by the Publisher. If you qualify for a free subscription to Washington Technology, you will begin to receive your bi-weekly issues in 4-6 weeks. If, for some reason you do not qualify to receive a free subscription, we will contact you to offer you a year's subscription for only $49.00.

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