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Please fill out the following questionnaire.
After you have answered each question completely, please click
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FARM/COMPANY/SCHOOL NAME	FIRST NAME	LAST NAME

MAILING ADDRESS


CITY	STATE/PROVINCE	ZIP/POSTAL CODE	COUNTRY


PHONE	FAX	E-MAIL ADDRESS

HOW DID YOU FIND OUT ABOUT OUR SOFTWARE?

WHAT TYPES OF SOFTWARE ARE YOU INTERESTED IN?

ACCOUNTING
MAPPING
FINANCIAL ANALYSIS
OTHER

CROP/FIELD MANAGMENT
SEED MANAGEMENT
EQUIPMENT MAINTENANCE

WHAT TYPES OF LIVESTOCK SOFTWARE, IF ANY?

PUREBRED CATTLE
COMMERCIAL CATTLE
DAIRY CATTLE
SHEEP
OTHER

FEED LOT
HOGS
HORSES

WHAT TYPE OF COMPUTER DO YOU OWN?
IBM COMPATIBLE (Dell, Micron, Gateway, etc.)
MACINTOSH

ARE YOU CURRENTLY USING ANY FARM SOFTWARE?
YES
NO

IF YES, WHAT?

ARE YOU CURRENTLY USING ANY ACCOUNTING SOFTWARE?
YES
NO

IF YES, WHAT?

IN WHAT CAPACITY DO YOU WORK?

FARMER/RANCHER
EXTENSION AGENT
COMPUTER/SOFTWARE RESELLER
OTHER

FARM BUSINESS MANAGER
AG CONSULTANT
AG EDUCATOR

WOULD YOU LIKE SOMEONE TO FOLLOW UP WITH YOU IN A COUPLE OF WEEKS?
YES
NO

COMMENTS

Vertical Solutions
203 11th Ave. SW, Minot, ND 58701
(800) 396-3279 or (701) 839-1195
e-mail: vertical@srt.com