Contact Information Salutation Mr. Mrs. Ms. Dr. * First name: * Last name: * Title: * Company Role: Select Role Trainer Business Development Software Developer Hardware Developer Sales Engineer Product Specialist LAN Administrator Technician Consultant Purchasing Manager Web Developer/Implementer IT Manager Marketing Manager Developer * Where did you hear about us? Select One PC Magazine Training Magazine IT Training Magazine Windows & .NET PC World Linux Journal Word of Mouth The Internet Trade Show Please list the name of your XStream Software Inc. corporate account manager (if applicable): Business Information * What is the nature of your company's business? Select Nature High Technology Software Development Telecommunications Banking Insurance Financial Services Consumer Products Consumer Durables Industrial Products Utilities Government Media VAR/Resellers Distributors Trade Manufacturing Automobiles Marketing Health Care/Hospital * Company name: * Address: Address cont.: * City: * Country: <Select> United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia & Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Terr. Brunei Darussalam Bulgaria Burkina Faso Burma (Myanmar) Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Rep Chad Chile China Christmas Island Cocos (Keeling) Isles Colombia Comoros Congo Congo, The Democratic Rep Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metro French Guiana French Polynesia French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Isles Holy See (Vatican) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast (Cote D'Ivoire) Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Dem People's Rep Korea, Republic Of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia (Republic of) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Fed States Moldova, Rep Monaco Mongolia Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Isles Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts & Nevis Saint Lucia Saint Vincent & Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Seychelles Sierra Leona Singapore Slovakia (Slovak Rep) Slovenia Solomon Islands Somalia South Africa S Georgia & Sandwich Isles Spain Sri Lanka St. Helena St. Pierre & Miquelon Sudan Suriname Svalbard & Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States US Minor Outlying Isles Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Isles (British) Virgin Isles (U.S.) Wallis & Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe None * State or Province: Select a State or Province * ZIP or Postal Code: * E-mail: Note: General e-mail accounts (e.g., Yahoo, Hotmail, etc.) will not be accepted. Please provide a valid e-mail address. * Phone: Extension (if any): Fax: Survey * If you were to purchase Linux Simulator technology within the next 6 months, how many developer licenses would you be interested in purchasing: Select One 1-2 3-4 5-10 10 and over Number of computers in your company: 1-4 5-9 10-19 20-199 200-499 500 or more Number of employees staffed by your company: 1-10 11-25 26-49 50-100 101-1000 1000 or more Number of NT Workstation machines: 1-4 5-9 10-19 20-49 50-199 200 or more Number of UNIX machines: 1-4 5-9 10-19 20-49 50-199 200 or more Number of Macintosh machines: 1-4 5-9 10-19 20-49 50-199 200 or more We thank you for taking the time to provide us with this valuable information.