All Fields marked with are required

Name:
Organization:
Title:
Address:
City/State:	Country: Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belgium Belorus Bolivia Brazil Bulgaria Burma Canada Cambodia Chile P.R. China Colombia Costa Rica Cuba Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Estonia Finland France Georgia Germany Greece Guatemala Haiti Holand Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Japan Jordan Kazakhstan Kenya Korea Latvia Lebanon Lithuania Luxembourg Malaysia Mexico Morocco Netherlands New Zealand Nicaragua Nigeria Norway Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Rumania Russia Saudi Arabia Serbia Silesia Singapore Slovenia South Africa Spain Sweden Switzerland Syria Taiwan Thailand Tunisia Turkey Ukraine United Kingdom United States Uruguay Venezuela Vietnam
Email:
Website: (if any)

Vertical Market:	TV Station Cable TV Video Production (Origination) Video Post-Production (Editing/Effects) Film Production & Post Facility Corporate Video Studio Educational Video Studio Government/Military Video Facility Hospital/Healthcare/Scientific Video Facility Advertising/PR Agency Multimedia/Computer Graphics Facility Hotel/Motel/Entertainment Professional Audio Facility Other
Other (please specify):

For each of the following products, check for each, whether your facility has a) purchased in 2008, b) Purchase/consider for purchase in 2009 or c) Consider for 2010 (check all that apply).

PRODUCT	2008	2009	2010
Camcorders
Camera Mounting Systems
Video Cameras
Character / Logo Generators
Clip/Still Stores
Telecine / Film scanners
Digital Effects Processors
Terminal Equipment (A/D's, DAs, Proc. Amps
Editing Systems - Non Linear Editing Systems (NLE’s)
Composite/Component Encoders/Decoders
Video Compression Encoders/Decoders/Transcoders
Graphics & Effects Software (not incl. computer workstation/s)
Graphics & Effects Workstations / Systems (not incl. software)
Master Control Switchers
Production/Post Switchers
Up / Down Convertors
Routing Switchers
Standards / Formats Convertors
TBC's / Frame Synchronizers
RAID Video Storage
Video Disk Recorders
Video Servers
Video Monitors
Video Test & Measurement
VTRs