XChange Public Sector
June 14-16, 2010
Sawgrass Marriott, Jacksonville, FL

Thank you for your interest in attending XChange Public Sector.

Taking a Leadership Role in Today's Economy.

This event is dedicated to the unique dynamics of the public sector market. There will be over 180 pre-qualified leading public sector integrators from across the U.S. Focus is on state, local, federal, and education channels. Sessions led by the senior editors of Everything Channel, and a Public Sector Awards Ceremony.

For more information please contact CT Thomas at 949-223-3634 or ct.thomas@ec.ubm.com or Tracy Fischer at 516-562-5337 or tracy.fischer@ec.ubm.com

Please note: Due to limited seats at the event, your registration does not guarantee attendance.

•Required Information
•First Name:
•Last Name:
•Job Title:
•Company Name:
•Address Line 1 :
Address Line 2 :
•City:
•State:
•Zip:
•Telephone:   Ext: 
•Cell Phone:
•Email:
•Website:
Which of the following markets segments are of interest to your organization:
•First Choice:
•Second Choice:
•Third Choice:
•To what degree are you responsible for building the vendor partnerships and alliances for your company:
•Have you ever attended a multi-day XChange event:
(XChange Solution Provider, XChange, XChange Tech Innovator)
•Does your company have a practice area/division focused on the government sector?
•Are you part of this practice area?
•What percent of your total revenue is derived from selling into the following markets? (Please note: must add up to 100%)
Federal Government %
State/Local Government %
Education %
Healthcare %
Corporate Business %
Please tell us which vertical markets you target: (Please hold down the Control key to select multiple answers)
 
Which of the following technologies do you provide? (Please hold down the Control key to select multiple answers)
 
What are your entire firm's approximate gross annual sales?
(Example: ($5.5 Million)
What is the number of employees in your entire organization (including all divisions, branches, and subsidiaries)?
What year was your company established?
What territory does your company cover?
Do you sell your own branded products (hardware or software)?
What percent of your total revenue is derived from each of the following?
Hardware Sales: %
Software Sales: %
Services/Support Sales: %
Is your company on a GWAC?
Which (if any) SBA certifications do you hold (Please hold down the Control key to select multiple answers)
What percentage of your company’s revenue is generated from the following agencies? (Please note the totals must total 100%)
Federal:
Department of Agriculture%
Department of Interior%
Department of Commerce%
Department of Defense%
Department of Labor%
Department of Education%
Department of State%
Department of Energy%
Department of Transportation%
Department of Health and Human Services%
Department of Homeland Security%
Department of Veterans Affairs%
Department of Housing and Urban Development%
Environmental Protection Agency%
Other %
State & Local Government:
Administration and Finance (includes Revenue/Tax)%
Health%
Human Services%
Transportation%
Public Safety%
Criminal Justice%
Public Works%
Natural Resources%
Other %
Total%
Which of the following vendors' products does your company resell? (Please hold down the Control key to select multiple answers)
Which of the following partner programs does your company participate in? (Please hold down the Control key to select multiple answers)
Please list three of the vendors you would like to see that were not included in the above list. 1.
2.
3.
Please identify your company's primary and secondary distribution partners.
Primary Distributor
(Select One)		 Secondary Distributor
(Select All)		  
Arrow
ASI
Avnet/Hallmark
Catalyst/Telecom
CDW/CDWG
Comstor
D&H
Ingram Micro
Scan Source
SED
Synnex
Tech Data
Tessco
Westcon
Other
If Other:
How do you expect your company's gross revenue (sales) to change during the next 12 months?
What is the total value of Hardware, Software, and Services that you will purchase this year from distribution, manufacturers, other Solution Providers, or any other source as elements to the solutions you will deliver to your clients?

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