| ABOUT YOU: |
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Courtesy
Title |
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Mr.
Ms.
Mrs.
Miss
Dr. |
First
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Middle Initial:
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Last
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Suffix:
(Sr., Jr., III, etc.) |
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Nick Name:
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Job
Title: |
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Contact
Phone: |
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(Extension:
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Contact
Fax: |
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Contact
E-mail: |
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| ABOUT YOUR COMPANY: |
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Company
Name: |
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Address
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Address
Line 2: |
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City |
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State /
Province |
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Country: |
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Is the above address your company's:
Main/Corporate Office
Remote Office |
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What is the URL (address) of your company's
Web Site?
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Please check the Major Geographical Areas for the scope of your
company's practice: |
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National (All of USA) |
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USA Mid-Atlantic - DC, DE, MD, NJ, PA, VA, WV |
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USA Central - IL, IN, MI, OH, WI |
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USA Pacific - CA, WA, OR, HI, AK |
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USA Northeast - CT, MA, ME, NH, NY, RI, VT |
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USA Southeast - AL, FL, GA, KY, LA, MS, NC, SC, TN |
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USA Southwest - AR, KS, MO, OK, TX |
USA West - AZ, CO, ID, IA, MN, MT, NE, NM, ND, NV,
SD, UT, WY |
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Canada |
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Mexico |
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Central America |
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South America |
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Other (Specify:
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The next sections cover the Vertical Markets
and Consulting Services in which your business is involved.
To properly develop support information for you and your client
base and to help us in referring business to you, please
rank the top five Vertical Markets and the top five Consulting
Services in order of importance to your business.
Type the number "1" in the box next
to the most important, "2" in the second most important,
etc. The number "5" should represent the least important.
If you are involved in more than five Vertical Markets or more
than five Consulting Services, rank the top five in each
category, then continue to rank any others as "6", "7",
"8", etc.
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Rank the top five Vertical Markets in which your company specializes.
Type "1" in the box next
to the most important, "2" in the second most important,
etc. The number "5" should represent the least important.
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Rank the top five Consulting Services that your company provides.
Type "1" in the box next
to the most important, "2" in the second most important,
etc. The number "5" should represent the least important.
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company's Principal Business revenue is based upon: |
Consulting
Analysis / Market Research / Publishing |
| Total consultants with your firm?
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| Client Engagements: |
| Total client engagements by your firm
within the past 12 months?
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| Of these total client engagements, please
estimate: |
Client Engagement
by Client Size |
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Client Engagement
by Line Size of Client |
| Client Size |
Percentage
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Line Size of Client |
Percentage
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| Fortune 500 |
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100 lines or less |
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| Fortune 501-2000 |
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101-400 lines |
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| Small Business |
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401-1000 lines |
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Total
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100%
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1001-4000 lines |
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4000+ lines |
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Total
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100%
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Total dollar potentials (in product sales) from recommendations to clients
for the previous calendar year, and the percentages of which were NEC:
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Last Year's Dollar Potential |
Percent NEC |
| PBX Systems |
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| Key Systems |
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| Data (IP, VoIP) |
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| Telecom Applications |
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| Contact Centers |
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| What percentage of your business (totaling
100%) within the past 24 months is by the following manufacturers? |
| Manufacturer |
Percentage
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Manufacturer |
Percentage
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| Avaya |
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Nortel |
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| Mitel |
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Siemens |
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| NEC |
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Toshiba |
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Other |
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Total
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100%
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| Please select your
top three preferred information delivery media: |
| First: |
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| Second: |
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| Third: |
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Please provide any additional comments:
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(Click "Submit" to send completed form.)
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