Please take a moment and answer the questions below to help us determine if an   OneGate Internet Access System is right for your company's Internet access needs.  * indicates required fields   If a field is not applicable, please type 'n/a' *Name:   *Title:   *Business/Org:   *Address:   *City:   *State/Provence:   *Zip/Mail Code:   *Country:   *Telephone:   Fax:   Email:   *Which of the following best describes your job function? Click to Select Executive Management (Chairman, President, VP, Owner, Principal) Department/Group Manager MIS/Data Communications Management Network Manager/Administrator Network Services Coordinator Teacher/Instructor/Educational Services Technical Services Consultant Real Estate VAR/Reseller Other If other, please specify: *Company/Business (Please tell us what your company does): Click to Select Advertising/Media Services Agricultural/Mining/Construction Banking/finance Education Government Health Care Insurance Legal Manufacturing Printing/Publishing Retailing Telecommunications Transportation Utility Wholesale/Reseller/Distributor Other If other, please specify: *Number of employees at this company location: Click to Select 1-25 26-100 101-200 Over 200   * Does your company have additional locations or branch offices? Click to Select none 1-5 5-10 Over 10   * What is your current Internet connection? Click to Select none Modem/dial-up ISDN Frame Relay/56K xDSL T1/FT1 Other   * Do you plan to upgrade this Internet connection?   If so to what? Click to Select No plans to upgrade Modem/dial-up ISDN Frame Relay/56K xDSL T1/FT1 Other   * When do you plan to upgrade your current Internet connection? Click to Select No plans to upgrade Within 30 days 30-90 days 3-6 months 6 months - 1 year   Who is your Internet Service Provider? How many e-mail accounts are active at your company? Click to Select 1-25 26-100 101-200 Over 200   How many e-mail accounts do you expect will be active at your company in one year? Click to Select 1-25 26-100 101-200 200-400 More than 400   Does your company have dedicated network management staff? Click to Select no 1 2-5 Over 5   What operating system is currently running on your company's PCs? (Check all that apply)  Windows 95  Windows 98  Windows NT  Macintosh  Other Does your company currently have a registered Domain Name?  Yes   No Does your company currently have a web site? Click to Select no web site Hosted by an ISP (or other provider) Hosted in-house   Does your company have an Ethernet LAN (10BaseT or 100BaseT) or Ethernet Hub in place?  Yes   No A Test Drive specialist will contact you to further discuss the program and your business needs.