To help us understand your needs, we'll need some information from you. Once we have your input, our systems engineers will make the best recommendations for you and and we will send you a complete packet of needs, costs, etc. OK, here we go:

What are your online needs? (Select all that apply):

Reseach via the Web
Send Receive Email
Corporate Intranet
Purchase from Suppliers

Communicate with Customers via the Web
Participate in Electronic Commerce
Use Newsgroups and Chat

If you have set a budget for Internet access, appoximately how much have you allocated per month?
Select an option... Less than $400 $400-$699 $700-$999 $1000-$1499 $1500-$1999 $2000+ Not decided

Do you Need extra security precautions, i.e., Firewall, Virtual Private Network?
Select an option... Yes No

What type of Internet access do you currently have?
Select an option... None Dedicated (24 hour Internet Connection) Dial-up (Connect to Internet on demand)

Do you have a corporate Web site?
Select an option... Yes No

How do you want to manage your Internet access equipment (router, CSU/DSU, diagnostic, modem etc.)?

Already have all necessary equipment
Install, maintain and administer ourselves
Outsource installation, maintenance and administration

Purchase or Lease ourselves
Outsource to ISP
Not sure yet

Do you prefer to handle your Internet address tasks (Domain Name System [DNS])?
No Yes

How many individuals will use your Internet access?
Select an option... Less than 10 10-49 50-99 100-499 500+

Are purchasing decisions made locally or at another corporate location?
Select an option... Locally Corporate Headquarters

Do you need to transfer files?
Select an option... Yes No

If you do transfer files, what types do you transfer? (select all that apply)

Graphics (jpg, gif, tif, etc.)
Streaming Audio
Text, spreadsheets, word processing documents

Streaming Video
Other

How many locations does your company have? Select an option... 1 2-5 6-10 11-15 16+

Contact Information:
Please contact me to discuss how World View Resources can help my business.

First name: Middle Initial: Last Name:
Title:
Company Name:
Address 1:
Address 2:
City: State: Select a state... Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP/ZIP+4: -
E-mail:

Telephone: - -
(i.e., 270-555-1234)

Fax: - -
(i.e., 270-555-1234)

Comments: