Provide only the information you feel is necessary. Name: E-mail: Telephone: (with area code) Job Title: Company Name: Address: Type of Business: What services are you interested in? Strategic Planning, Consulting Multimedia content design Product catalogs Electronic commerce Web hosting Internet presence (virtual corporations; unlimited e-mail) Intranet design What is the purpose of your Web site? Corporate Presence on the Internet Marketing Sales Customer Support Live Event or Webcast Project time frame?: Under three months 4-12 months Over 12 months How did you hear about Madeonamac?