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First name * Last name * Company name * Title * Division/Mail Stop Street Address * City * *USA/CANADA/U.S. MILITARY State Select State/ProvinceAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming-------------------------------------U.S. Military - Overseas Europe (AE)U.S. Military - Overseas Pacific (AP)-------------------------------------ALBERTABRITISH COLUMBIAMANITOBANEW BRUNSWICKNEWFOUNDLANDNOVA SCOTIANORTHWEST TERRITORYONTARIOPRINCE EDWARD ISLANDQUEBECSASKATCHEWANYUKON TERRITORY Zip *USA/U.S. MILITARY: Enter zip +4 codes without a hyphen (e.g. 123456789) *CANADA: Enter postal codes per usual (e.g. A1B 2C3) OTHER: Enter zip/postal codes per usual, if applicable Country USA CANADA OTHER: Please specify *Please indicate your country of delivery. 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Box or Street Address ** City ** **USA/CANADA/U.S. MILITARY State Select State/ProvinceAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming-------------------------------------U.S. Military - Overseas Europe (AE)U.S. Military - Overseas Pacific (AP)-------------------------------------ALBERTABRITISH COLUMBIAMANITOBANEW BRUNSWICKNEWFOUNDLANDNOVA SCOTIANORTHWEST TERRITORYONTARIOPRINCE EDWARD ISLANDQUEBECSASKATCHEWANYUKON TERRITORY Zip/Postal Code **USA/U.S. MILITARY: Enter zip +4 codes without a hyphen (e.g. 123456789) **CANADA: Enter postal codes per usual (e.g. A1B 2C3) OTHER: Enter zip/postal codes per usual, if applicable Country: SELECT ONE USA CANADA OTHER: Please specify **Please indicate your country of delivery. OVERSEAS U.S. MILITARY: Select USA and verify that you have entered your zip/postal code above.   QUALIFICATION FORM Please answer all of the following questions: I wish to receive/continue to receive a free subscription to Inter@ctive Week. Yes No 1. What is your organization's primary business function? SELECT ONE ONLY Internet Service Provider Commercial/Internet Online Service Telecommunications, Long Distance, or Cable Company Providing Internet Access Provider of Web Hosting Services Finance/Banking/Insurance/Real Estate Health/Medical/Legal Transportation/Travel/Hospitality Entertainment Media & Publishing Broadcast Retail/Wholesale Trade Government - Local/State/Federal Education Advertising/Public Relations R&D Labs Aerospace Construction/Engineering/Architecture Manufacturing (non-computer, cable or telecom related) Competitive Local Exchange Carrier (CLEC) Competitive/Alternate Access Provider (CAP) Interexchange/Long Distance Carrier (IXC) Independent/Incumbent Local Exchange Carrier (ILEC) Data Service Provider Cable Operator (MSO and Independent) RBOC/GTE Utility Providing Communications Services Wireless Service Provider (such as PCS, Cellular, Paging) Communications Systems Integrator Web/Software Developer Computer Manufacturers Communications/Network Manufacturers Cable Equipment Manufacturers Computer/Internet Resellers/VARS/System Integrators Computer/Internet Consulting Other If you selected "Other," please provide your organization's primary business function: 2. What is your job function? SELECT ONE ONLY Internet/Intranet Management Interactive/New Media Management Electronic Commerce Management Applications Development Management Web Developer Webmaster CIO/Senior IS Management IS Operations Management IS Engineering/Technical Management Communications Management Senior Networking Management Network Engineering/Technical Management Network Planning and Design Management Executive Management Marketing Management Business Divisional Management Financial Management Consulting Other If you selected "Other," please provide your job function: 3. In what ways is your company involved in Internet, Intranet, Extranet or World Wide Web implementation? (Check ALL that apply) For internal company applications (such as Intranets, e-mail, group collaboration and Web hosting) For external company applications (such as electronic commerce, marketing, Web publishing and e-mail) As a provider of network services (such as Internet access, Web development, local telephone, long distance, cellular/wireless or cable services) As a developer/supplier of content As a consultant to companies developing Internet, Intranet, Extranet or World Wide Web applications Other: None of the above 4. What types of products and services do you personally specify, recommend, approve, purchase or influence the purchase of for Internet, Intranet, Extranet or World Wide Web implementation? (Check ALL that apply) Network Infrastructure (including switches, routers, WANS, transmission equipment, LANs, and network management) Computer Hardware (including servers, workstations, personal computers, storage, printers and other peripherals) Computer Software (including operating systems, database, business applications, development tools) Electronic Commerce (including hardware, software, networks and tools for electronic commerce applications) Internet Access/Web Hosting (including Internet access, Internet services, Web services, content development, Website development) Internet/Intranet/Extranet Tools (including hardware, software, browsers, search engines, applications development tools) Communication Services (including local service, long-distance service, leased lines, systems integration, ISDN, cellular and wireless) Other: None of the above 5. In which of the following ways are you personally involved in interactive initiatives for your company? (Check ALL that apply) Authorize purchases Help decide vendor/brands to be used Participate in developing products and/or services Work on strategic alliances Provide technical management/support Other: None of the above 6. What is the highest level for which you specify, recommend, buy or approve the purchase of computer, communications, Internet or Extranet products or services? SELECT ONE ONLY More than one company Entire enterprise at more than one location Department or division at more than one location Entire Location Multiple departments at one location A single department Workgroups Myself Not involved 7. What is the scope of your personal involvement in purchasing products and/or services for your organization? SELECT ONE ONLY Both domestic and international Domestic only International only Not involved 8. From which type of providers do you buy services for your organization? (Check ALL that apply) Bell or GTE Local Exchange CLEC Long Distance Commercial/Internet Online Service Internet Service Provider Competitive/Alternate Access Provider Cellular Provider Wireless Provider PCS Service Provider Cable Company Paging and Message Provider Other:   None of the above 9. What is the estimated value that you personally will help specify, recommend or approve for purchase in the next 12 months, on products and services for Internet-related activities? (Select one entry per category) Network Infrastructure SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Computer Hardware SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Computer Software SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Internet Access/Web Hosting (including Web management and development) SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Internet/Intranet/Extranet Tools SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Communication Services (including long distance, local, wireless, cellular, PCS, cable) SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Electronic Commerce SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above 10. What is the estimated value that your entire organization will spend in the next 12 months, on products and services for Internet-related activities? (Select one entry per category) Network Infrastructure SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Computer Hardware SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Computer Software SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Internet Access/Web Hosting (including Web management and development) SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Internet/Intranet/Extranet Tools SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Communication Services (including long distance, local, wireless, cellular, PCS, cable) SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above Electronic Commerce SELECT ONE $100 million or more $25 million to $99,999,999 $10 million to $24,999,999 $5 million to $9,999,999 $1 million to $4,999,999 $500,000 to $999,999 $100,000 to $499,999 $25,000 to $99,999 $10,000 to $24,999 Less than $10,000 None of the above 11. In addition to applications involving the Internet, Intranets, Extranets and World Wide Web, what other types of network-based interactive initiatives is your company using, developing or reselling? (Check ALL that apply) Telecommuting Videoconferencing Computer Telephony Virtual Private Networks Data Warehousing Remote Classroom/Training Remote Access IP Services Other:   None of the above 12. Which of the following are now being used or will be used in the next 12 months by your organization for Internet, Intranet, Extranet or World Wide Web initiatives? (Check ALL that apply) Java Windows NT UNIX Sun OS/Solaris Apple Mac OS Netware/Intranetware  Linux None of the above 13. Which of the following Internet-related IT initiatives are you involved in? (Check ALL that apply) Network Management Network Security Access to Legacy Applications Database Management Data Warehousing/Mining  Storage Management None of the above 14. Approximately how many people are employed in your entire organization, including all of its branches, subdivisions, and subsidiaries? SELECT ONE ONLY       20,000+ 10,000 - 19,999 5,000 - 9,999 1,000 - 4,999 500 - 999 100 - 499 1 - 99 15a. Would you like to receive The Inter@ctive Week E-Mail Alert, a twice weekly newsletter that covers all the news and special features on Inter@ctive Week Online? Yes    No If you selected "Yes," please verify that your E-mail Address has been entered. 15b. Would you like to receive free and discounted offers from other companies via email? Yes     No If you selected "Yes," please verify that your E-mail Address has been entered. In order to verify your request for this publication, without the availability of a signature our audit bureau requires that we ask a personal identifying question. This information is used solely for the purpose of auditing your request. What is your eye color? SELECT ONE ONLY       Brown Blue Green Hazel Black Grey