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Type Information Request

Respondents Details
Name (Contact Person):
Position:
Company Name:
Trading Name (leave blank if same as above):
Name of other people involved in the project:
Position:
Address:
Country:
Telephone:
Fax:
URL?
Email:

Your Profile
Select the business category that best matches your profile!	Consumer Collection Agency Commercial Collection Agency Legal Collection Agency Consumer and Commercial Collections
About the Debt Collection Software you are currently using?	The name of the Application: Windows Based It is not Windows Based I don't have any Debt Collection Software
Timeframe for implementation of new system?	Less than 1 month 2 Months 3-6 Months 7-9 Months 10-12 Months Not yet scheduled! Other
Number of Users	Number - current application Number - required for new system
Reason for changing to a new system?
Your requirements of a New Collection System:
Current Server Operating System:	Windows 2003 Server Windows 2000 Server Windows NT Server 4.0 Windows 98/95 Other
Current Workstation Operating System:	Windows XP Professional Windows 2000 Professional Windows NT Workstation 4.0 Windows 98/95 A mix of Windows 95/98 & NT Workstation Other

Product Inquiry
Please select the product you require information on:	Wincollect Standard Wincollect Professional Wincollect Enterprise Suite Wincollect Enterprise Suite with Web-collect.net
If you purchased Wincollect would you also purchase onsite training?	Yes Possibly No
Have you viewed the Live Demonstration?	Yes No No - but I would like to be able to view it.
How did you first come to here about Wincollect?	Internet Search Advertisement Word of Mouth

Additional Comments
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