We would like to introduce ourselves and to add you to our growing list of satisfied customers. For more information, please take a few minutes to fill out the information below or call us at 1-800-266-7988, extension 208.

If you have any questions, don't hesitate to call us or contact us by e-mail at kate@cprops.com.

We look forward to working with you very soon!

Contact Information
Contact Name:
Agency Name:
Street Address:
City:
State:
   Zip Code:
Phone Number:
 Fax Number:
E-mail Address:
Web Site Address:

Do you have the authority to purchase this software for you agency?

   Yes No
If no, provide the name of the
person who does:


 Phone
Number:

Agency Information

How long has your company been in business?

   Less than 1 year
1 to 4 years
5 to 10 years
More than 10 years

Approximately how many active clients does your agency currently service?

 1-500
500-1,000
1,000-5,000
5,000-10,000
10,000-50,000
50,000+
What is your current growth expectation?
Number of Users:
   Number of Computers:
Number of Servers:

System Information

What Operating Systems does your agency use?

   Windows 98
Windows 2000
Windows XP
 Other (Please specify)

What application are you currently using?:

Are you satisfied with your current application?

   Very Unsatisfied
Unsatisfied
Satisfied
Very Satisfied
What major functionality would you like to have in place that you currently do not have?
What are your agency's primary expectations for this project?

Will your existing database require conversion?

   Yes No

What is your expected time frame for the implementation of a new application?

 Less than 1 month
1 to 3 months
4 to 12 months
More than 1 year