Name

Company Name

Address

City

State

Zip

Phone

Fax

e-mail

Servers installed:

AS400 (iSeries)

NT 4.0

W2K Server

Linux

RS6000 (pSeries)

Unix Host

Domino

S390 (zSeries)

Industry

Manufacturing

Healthcare

Distribution

Government

Retail

Other:

Do you currently create any barcodes?

YES NO

What type of barcodes do you intend on creating? (check all that apply)

3 of 9 2-5 UPC AG/IG
Other:

Timeframe for deployment?

Immediate 30 days 1-3 months 4-6 months 6+ months

I heard about these products from…

Direct mail piece

Trade show/seminar

Display ad in magazine

Yahoo/Web search

Referral

Other