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Dear Customer,

Thank you for your interest in Ceedo. Please use this form if you would like someone from Ceedo to contact you regarding Ceedo Enterprise, or if you would like to receive an evaluation copy of Ceedo Enterprise. In order that we may best serve you, please tell us about yourself.

I am...

An existing customer
A prospective customer
A Value Added Reseller (VAR)
An industry analyst
Member of the Press
System Integrator
OEM

Personal Information

Name:

Company:

Title:

E-mail address:

Office Phone number:

Other Phone number:

How would you prefer to be contacted?

	Phone (Office)
	Phone (Other)
	Email

Prospective Customers, please tell us about your project:

	1. Primary Goal:
	Mobilize our workforce
	Deploy a managed PC-environment to external company agents
	Enable our customers to securely work within our infrastructure (banking)
	Other

	2. Industry:
	Insurance Agents
	Loan Brokerage
	Home Health Care
	Banking
	Other

	3. Time Period (full deployment):
	ASAP
	3-6 months
	6-12 months
	12-24 months
	Longer term

	4. Size of project (approximate):
	10+ seats
	20+ seats
	50+ seats
	100+ seats
	1000+ seats
	1,000+ seats
	10,000+ seats

Additional Information

Additional Information that may help us to understand your needs:

Please check your request information and make sure you have included as much information as possible.