ONLINE APPLICATION

Please complete the application now to qualify for the Midsize Enterprise Summit Regionals in the region nearest you.

If qualified, you will receive an email with your username and password to complete your Guest Registration Form.

* Required Information
* Please select the Event that you are geographically closest to.
Select a Summit
      
       
* Are you new to the Midsize Enterprise Summit?
Yes, I am new     No
Salutation Mr.    Ms.    Dr.
First Name*
Last Name*
Title*
Organization*
Street Address*
City*
State*
Zip*
Telephone*
Fax
E-mail Address*
Web site*

Please take a few minutes to answer the following questions so we can better serve you:

1. What best describes your organization's primary industry?

Other

2. Who do you directly report to within your organization?

Other

3. How many people are employed in your entire organization?
1-99 1,000-2,499
100-249 2,500-4,999
250-499 5,000-9,999
500-999 More than 10,000

4. How many people are employed in your IT Department?
1-5 21-50
6-10 50-100
11-20 100+

5. What is your organization's total annual revenue?
Less than $50 million $500 million - $749 million
$50 million - $99 million $750 million - $1 billion
$100 million - $249 million More than $1 billion
$250 million - $499 million Other:   

6. What is your organizations annual IT budget, excluding payroll?
Less than $1 million $50 million - $100 million
$1 million - $5 million $100 million - $500 million
$5 million - $10 million More than $500 million
$10 million - $50 million  

7. What is your role in IT purchase decisions?
Final Decision-Maker
Decision Influencer
Recommend Products/Services

8. Briefly describe any big projects or implementations you are currently undertaking and what the objectives are.

Thank you for your interest in the Midsize Enterprise Summit Regionals!