Mobile Computing and Communications Magazine -- Requalification Form Attention Industry VIPs: Protect Your Exclusive Subscription Offer In order to continue receiving Mobile Computing & Communications, FREE of charge, please complete the form below and send today! Instructions: Please complete the form below and e-mail to the following: mobile@mbagroup.com. Make sure to answer all the questions. --------- Begin Form --------- Mobile Computing & Communications Magazine -- Requalification Form Given that there is no way for you to sign this electronic form, our audit agency REQUIRES the answer to a personal question. Please first indicate the month of your birth: [ ] Please put an 'x' in one of the following options: [ ] YES! Please renew my subscription. [ ] No, please do not renew. Our most current records show us the following information. If the information is no longer current, please be sure to fill out the "Change-of-Address" section below.
<Change of Address Section (Please skip this section if there are no changes)>: [ ]: Name [ ]: Title [ ]: Company [ ]: Address [ ]: City [ ]: State [ ]: Zip [ ]: Phone [ ]: Fax [ ]: E-Mail <End of Change of Address Section> Today's Date: [ ] Are you personally responsible for the recommendation, specification, authorization and/or purchase of mobile computing products for your organization? (Please 'x' only one): [ ] Yes [ ] No For how many people at your company do you personally recommend, specify, authorize and/or purchase mobile computing products?: [ ] 1 to 25 [ ] 26 to 100 [ ] 101 to 1,000 [ ] More than 1,000 What is your organization's primary business activity at this location? (Please 'x' only one): [ ] (01) Manufacturing and Process Industries [ ] (02) Banking [ ] (03) Finance/Accounting [ ] (04) Insurance/Real Estate/Legal [ ] (05) Medical/Dental/Healthcare [ ] (06) Communications Carrier [ ] (07) Transportation/Utilities [ ] (08) Retail/Wholesale/Distribution (non-computer) [ ] (09) Construction/Architecture/Engineering [ ] (10) Media/Marketing/Advertising/PR [ ] (11) Business Service (non-computer) [ ] (12) Consultant (non-computer) [ ] (13) Entertainment/Travel/Hospitality/Recreation [ ] (14) Aerospace [ ] (15) Agriculture/Forestry/Mining/Oil/Gas [ ] (16) Research/Development Lab [ ] (17) Non-profit/Trade Association [ ] (18) Computer/Data Processing Service [ ] (19) Computer Manufacturing (hardware/software) [ ] (20) Computer Related Retail/Wholesale/Distribution [ ] (21) Computer Consultant [ ] (22) VAR/VAD Systems or Network Integrators [ ] (23) Federal Government (incl. military) [ ] (24) State/Local Government (incl. military) [ ] (25) College/University/Library [ ] (99) Other (please specify): [ ] What is your primary job function? (Please 'x' only one): Computer Systems/Operations Network [ ] (A) IS/MIS/DP: Centralized [ ] (B) IS/MIS/DP: Departmental [ ] (C) LAN/Network Systems [ ] (D) Data Comm/Telecoms [ ] (E) PC/Micro Systems/Info Center [ ] (F) Computer Operations/Systems [ ] (G) Systems Analyst/Programming [ ] (H) Software/Applications Development [ ] (I) Systems Engineering/Integration/Technical Services [ ] (J) Desktop Publishing/Word Processing [ ] (K) Other Computer Related
Administration/Department/General Management [ ] (L) Corporate/Senior Management [ ] (M) Financial/Accounting [ ] (N) Engineering [ ] (O) Advertising/Sales/Marketing [ ] (P) Purchasing [ ] (Q) Manufacturing/Production [ ] (R) Research & Development [ ] (S) Other Department Management
Professionals and Others [ ] (T) Computer Related Consultant [ ] (U) Training/Education [ ] (V) Other Professionals (legal, medical, architect, etc.) [ ] (Z) Other (please specify): [ ]
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