Optional
First Name:
Job Function:
Last Name:
--Please Select One--
Business Focus: Corporate/General/Finance
Business Focus: HR/Training/Education
Business Focus: Development/Planning/Manufacturing/Engineering
IT Focus: Executive IT
IT Focus: General IT Management
IT Focus: Networking/Communications
IT Focus: Security/Compliance
IT Focus: Systems Integration/Engineering
IT Focus: Application Development
IT Focus: Web Development/Maintenance
IT Focus: Operations (Data/Call Center/Service/Support)
IT Focus: R&D
IT Focus: Data/Database Arch/Admin
Other
Company:
Title:
Address:
Work
Home
--Please Select One--
CEO/COO/Chairman/President/Owner/Partner/Principal
CIO/CTO/CSO/CISO
CFO/Treasurer/Controller
EVP/Executive Director/SVP/Managing Director/GM/VP
Director/Manager/Supervisor
Professional (e.g. Attorney, IT Developer, Architect, etc.)
Administrator/Coordinator/Specialist
Consultant
Other
Street:
Industry:
--Please Select One--
Tech: Communication Carriers (ISP, Telecomm, Data Comm, Cable)
Tech: Computer/Network Consultant
Tech: E-commerce/Internet
Tech: Manufacturing - Hardware
Tech: Manufacturing - Software
Tech: Retailer/Distributor/Wholesaler (computer-related)
Tech: Service Provider (MSP, BSP, ASP, ESP, Web Hosting)
Tech: VAR/VAD/OEM
Non-Tech: Advertising/Marketing/PR/Media (Print, Broadcast, Web)
Non-Tech: Agriculture/Forestry/Fisheries
Non-Tech: Business Services/Consultant
Non-Tech: Construction/Architecture/Engineering
Non-Tech: Aerospace/Defense Contractor
Non-Tech: Education
Non-Tech: Finance/Banking/Accounting
Non-Tech: Government - Federal (including Military)
Non-Tech: Government - State/Local
Non-Tech: Healthcare/Medical/Pharmaceutical/Bio-Tech
Non-Tech: Insurance/Real Estate/Legal
Non-Tech: Manufacturing & Process Industries
Non-Tech: Mining/Oil/Gas
Non-Tech: Retailer/Wholesaler/Distributor (non-computer)
Non-Tech: Travel/Hospitality/Entertainment/Recreation
Non-Tech: Transportation/Utilities (Energy, Water, etc.)
Other
City:
Company Size:
State:
N / A
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
AE
AA
AE
AE
AE
AP
--Please Select One--
Less than 50
50-99
100-499
500-999
1,000-4,999
5,000-9,999
10,000-19,999
20,000-29,999
30,000-39,999
More than 40,000