Please note: Although it is most unlikely that you will experienceany
problems responding to this form, certain non-standard browsers will
not respond properly. If you experience any difficulties,
(or if you arenot using a forms-capable browser) you may email your
response to thisform to: E-Mail

BCD Quotation Form Below:

FAX IT NOW FORM

      First name   Required
       Last name   Required
          E-mail   Required
           Title      
         Company 
  Street address 
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal code    
         Country 
      Work Phone 

     Pager Number

I interested in BCD Fax It Now system for ;
Myself
My Company (Please continuewith the next question.)
My Home-Based Business (Pleasecontinue with the next question.)

What is the primary business of your organization at your location?
accounting/financial/banking advertising/public relations aerospace agriculture automotive aviation chemical church/religous communications computer construction/building consulting/planning electronics entertainment food/beverage government agency graphics healthcare/medical/hospital higher education hotel insurance internet access provider janatorial/maintenance K-12 education legal manufacturing other pharmaceuticals printing/publishing real estate research retailer telecommunications transportation utility wholesaler

How many locations does your company have in total, including all locations?
1-50 51-150151-1000 1001-50005001+ n/a

What is your primary job function?
Owner President ISManagement Creative/Content Management Executive Management Sales/Marketing Management Operations Manager FinanceManager Engineer Clerical Teacher/Professor Student Other

Which statement best describes your role in the purchasing of advertisingand marketing?
I dicide all marketing.
I set company standards for marketing.
I evaluate and recommendadvertising and marketing.
I have some influence inthe advertising and marketing .
I control all advertising andmarketing.

Does your company have a fax or computer modem fax software?
Yes NoDon't Know
If yes:

• What type of fax plain paper / fax software?
• Does your company have internet access?
  Yes No
• If no would you like to know about internet accesss and how it works?

Yes No

Does your company have an E-MAIL address?
Yes NoDon't Know

If yes what is your E-MAIL address?

E-mail

Will you or your company be making a purchase or evaluation decisionon marketing your firm in the near future?
Yes NoDon't Know
If so, how soon will that decision be made?
1-3 months 3-6months 6-12 months Don'tknow

Ocasionally we send information about The BCD Online (bcd)and specials to our customers. If you do want to receive these offers,please check below.
By mail Byemail

E-MAIL

Top

Return to the BCD HomePage

CONTACT INFORMATION
 

e-Mail stewie_gr1ff1n@hotmail.com

Last modified:  Sunday, March 01, 2009 10:16:07 PM