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If you would like a Zelacom representative to contact you, please fill out the form below. I am interested in: Web site design Hosting/domain name registration Internet consulting Other:        Name Title Company Name Street Address City, State, Zip Email Phone Fax Best way to reach you Email   Phone    Postal Mail The following fields are optional. If you wish to provide any of the following information, we will be better equipped to assist you when we respond. When you are finished, scroll down and click on the SUBMIT button. 1. What is your type of business or organization? 2. What is your primary responsibility? Executive Finance MIS Operations Sales/Marketing Training Other Details/Other: 3. What is your primary product or service? 4. Who are your primary customers? 5. Which media do you currently use to reach clients? (please check all that apply) Newspaper/Magazine advertising Print collateral (brochure, catalog, etc.) Trade publications Yellow pages Radio Television Telemarketing CD-ROM Video Email Internet banners, links Website Other:    6. How do clients currently contact you? (please check all that apply) Face-to-face Phone Fax Postal Mail Email Modem / WAN connection 3rd party sales/account representative Reseller Other:    7. Do you currently have a homepage?  Yes     No     Under Construction If yes, please enter the complete URL:  8.  What else would you like us to know about you?