| 1)
Company/Organization |
| Business Name: |
Contact Person/Title: |
| Street: |
Phone: |
| City, State, Zip: |
Fax: |
| Webpage Address: |
Email: |
| |
| 2)
Information system location |
| Location Name: |
Contact Person/Title: |
| Street: |
Phone: |
| City, State, Zip: |
Email: |
| |
| 3)
Person in charge of information system |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 4)
Person approving software development / programming |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 5)
Technical person interfacing with programmers / technical support |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 6)
Network Administrator |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 7)
Technical person interfacing with programmers / technical support |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 8)
Billing Address |
| Street: |
Contact Person/Title: |
| City, State, Zip: |
Phone: |
| Purchase Order necessary? |
Fax: |
| |
| 9)
Accounts payable contact |
| Name/Title: |
Phone: |
| Email: |
Fax: |
| |
| 10)
Hardware / Software |
| Network software and version: |
| Server operating system: |
| Number of workstations/users: |
| Workstation operating system
software and version: |
| |
| 11)
Information System / Database |
| Database software and version: |
| Network add-on products (from
Revelation Technologies) being used: |
| Creator of database application: |
Phone: |
| Last programmer to modify system: |
Phone: |
| Communication software and version: |
| Tape backup model: |
| Tape backup software/version: |
| How long has database system been
in use? |
| How long has database system been
in use since time of last modifications? |
