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First Name: Middle Name/Initial: Last Name:
Spouse's First Name: Spouse's Middle Name/Initial: Spouse's Last Name:
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Your Ethnic Background:
Your Email Address: (example: yourname@yourdomain.com )
Please list your personal web site if you have one: (example: www.yourdomain.com)
Please list your pets at home (up to three):
Type: Select Dog Cat Fish (Tropical) Fish (Salt Water) Rat Hamster Rabbit Snake Iguana Bird Turtle Ferrets Other (Please Specify)
Type Select Dog Cat Fish (Tropical) Fish (Salt Water) Rat Hamster Rabbit Snake Iguana Bird Turtle Ferrets Other (Please Specify)
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Select Gender Male Female
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Please tell us about your work:
Company Name: What is your company size? Select Only 1 Employee 2- 5 Employees 6 - 10 11 - 20 20 - 35 36 - 50 51 - 75 76 - 100 101 - 500 501 - 1,000 1,001 - 2,500 2,501 - 5,000 5,001 - 10,000 10,001 - 50,000 50,001 - 100,000 100,000 +
What is your job title? Select Title President Sales Person Retail Sales Engr Mngr Sftwr Engr Hdwr Engr Other Engr Scientist WebMaster/Developer Technical Administrative Clerical Educational Instructor Student Retired CEO CIO CFO CTO VP IT/IS Admin IT/IS Mngr MIS Other
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Do you have a home office?
What industry are you in?
What kind of car(s) do you drive?
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Model:
Type: Select 2 door 3 door 4 door Truck SUV Minivan
Purchased New Used Leased
What type of desktop computer do you use? Select Use IBM Use IBM-Clone Use Mac Use Mac-Clone Use Other Use Both Don't use a desktop computer Select Style Desktop Laptop All-In-One Design Other
Do you have a DVD Drive?
What Operating System Do You Use?
Select Mac OS Mac OS 7 Mac OS 7.6 Mas OS 8 Mac OS 8.1 Mac OS 8.5 Mac OS 9 Mac OS X Other Select PC OS Windows 3.1 Windows 95 Windows 98 Windows 2000 Windows XP Windows NT Unix Other
Do you use a laptop? Yes No
If "yes", what kind? Select Windows Pentium Pentium II Macintosh PowerPC Use Other Use Both
Do you use a personal digital assistant (PDA)? Yes No
If "yes", what kind? Select Cassiopeia Compaq Newton MessagePad (120, 130, 2000, 2100) eMate 300 Nino PalmPilot Other
If yes, what kind of Personal Digital Assistant (PDA) operating system (OS) do you use? Select Personal Digital Assistant OS Win CE Newton OS 2.0 Newton OS 2.1 Other
What type of connection do you have to the Internet? Select Speed 9.6 k 14.4 k 28.8 k 33.6 k 56.6 k ISDN T1 Cable Modem DSL Modem Other None Select Modem External Internal Wireless Other None
At what level do you consider your computer skills? Select Level Novice Intermediate Advanced Programmer
Please list the two computer programs you use most:
Program 1:
Frequency: Select Usage Daily 3 times a week Once a week 2-3 times a month Once a month Less often
Please select the items that you own or use:
Color Scanner
CD ROM
Video Games
Color Printer
Digital Camera
Which of the following do you own or use? (Please select as many as apply)
Coffee
Microwave
VCR
Wine
Cable TV
MasterCard Credit Card
Beer
Digital Cable TV
Visa Credit Card
Liquor
Satellite TV
American Express Credit Card
Contact Lenses
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Discover Credit Card
Other Credit Cards:
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Please list your hobbies:
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