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MARCH 2011
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Section 1 Your Details Please complete in all cases
Name .............................................................................................................................................. Job title .......................................................................................................................................... Company ........................................................................................................................................ Address .......................................................................................................................................... ........................................................................................................................................................
Tel: ................................................................ Fax: ........................................................................ E-mail: ............................................................................................................................................
Section 2Job Function (Tick one box only) Corporate management IT management Marketing management Consultant Other, please specify..............................................................
Section 3Number of Employees (Tick one box only) 1-5 6-10 11-50 51-100 101-500 500 plus
Section 4Business Function (Tick all boxes that apply) Manufacturer Distributor VAR Systems Integrator Reseller OEM Software Developer Other, please specify...................................................................
Signature................................................................ Date ........................................ Only signed and dated forms can be accepted
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