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*First Name
*Last Name
Company Name
Address
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State
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Washington DC
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Zip
*Contact Phone
*Email Address
Web Address
Occupation:
[select occupation]
executive/managerial
professional (doctor, lawyer, etc.)
academic/educator
computer technical/engineering
other technical/engineering
service/customer support
clerical/administrative
sales/marketing
tradesman/craftsman
homemaker
self-employed/own company
Radio/Televsion
other
Industry
[select industry]
banking/finance/real estate
computer-related (IS, MIS, DP, Internet)
computer-related (hardware)
computer-related (software)
education, research
engineering/construction
manufacturing/distribution
business supplies or services
medical/health services
entertainment/media/publishing
hospitality (travel/accommodations)
consumer retail/wholesale
nonprofit/membership organizations
government
legal services
other
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