Your Information: * * * * Address 2: * * * * * Fax * Please tell us how you heard about Ortronics: Internet (URL): Trade Journal Select one: Cabling Business Cabling Installation and Maintenance Communication News Electrical Contractor Fiber Optic Product News Other Ad Press Trade Show Reference Other Please select which catalogs you would like us to send to you: * What is your company's role relative to Ortronics products? * Select one: Contractor/Installer Consultant/Designer Distributor End User Manufacturer/Reseller Other
If distributor; Are you currently an Ortronics distributor?
If other, please specify
What is your company's primary business?* Select one: ASP/CLEC/ILEC/ISP/POTS Bank/Finance/Insurance/Legal Broadcasting/Publishing Building Management Colocation/Datacenter/BLEC Commercial/Building Development Communication/Transportation/Utility Consulting Contracting/Installation Design/Engineering Services Distributor/Wholesaler/Reseller Education Government/Military Hospital/Healthcare/Hotel Industrial/Manufacturer Other Corporate Service Firm Residential Development Retail/Chain Other
If other, please specify:
What is your job function? * Select one: Architect Consultant/Designer Contractor/Installer IT/MIS Director Management: Corporate or General Management: IT or MIS Management: Operations Network/System Integrator Project Management Purchasing Agent/Buyer Sales Other
If other, please specify:
Do you make specifying or purchasing decisions for structured cabling products? *
If answer is No; Who does?
Name:
Phone: Which Ortronics products are you interested in? Current Project: * New Project Upgrade How many workstations or drops are being installed on the network? * Select one: 0-24 25-49 50-99 100-499 500-999 1,000-2,499 Over 2,500 Project Stage:* Select one: Pre-Planning Planning Final Planning Bidding/Purchasing Construction/Installation Other Purchasing Timeframe: * Select one: 0-2 months 3-6 months 7-12 months Over 12 months Indefinite Other Do you have an approved budget? *
What is the estimated budget for your structured cabling system needs? Select one: Less than $1,000 $1,000 - $4,999 $5,000 - $9.999 $10,000 - $24,999 $25,000 - $49,999 $50,000 - $99,000 $100,000 - $499,999 Over $500,000 Not sure Comments or Questions:
