Questionnaire

Serving Businesses Throughout
the North Eastern United States
Telephone & Fax: 866-844-9607

> Questionnaire

Preliminary Client Information

Company Information		Contact Information
Company Name:		Contact Name:
Address 1:		Assistant Name:
Address 2:		Contact Phone:
City:		Assistant Phone:
State:		Contact E-Mail:
Zip:		Assistant E-Mail:
Main Phone:		Direct Fax #:
Main Fax:		Contact Title:
Web Site:		Contact Reports to:

General Information
Type of Business	Service Manufacturing Distributor Professional
Business Volume	up to $100,000 $101,000 to $500,000 $501,000 to $1MM $1MM to $5MM $5MM to $25MM $25 to $100MM $100MM+
Number of Locations	One Two Three 4-5 6-9 Ten Plus
Number of PC's	One 2-5 6-10 11-25 26-100 101+
Number of Employees	Under 10 11-25 26-100 101+
Use Microsoft Office?	Yes No	Use Accounting Software?	Yes No
How do you see us helping you?

Preliminary Client Information