Please provide the following information:  (<R> = required information)

Name	<R>
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Organization
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City	<R>
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What Product(s) Are You Interested In? (check all that apply)	CHEM Master 2000 - vendor MSDS management, inventory, RTK compliance MSDS Generator 2000 - MSDS authoring (for your company's products)
What Compliance Task(s) Do You Need To Do? (check all that apply)	Chemical Supplier MSDS Management  Product MSDS Authoring  SARA/RTK reporting    Chemical Inventorying   Bar coding Regulatory Chemical Information  OSHA & RTK Labeling
If doing MSDS Authoring, how many MSDSs are needed?	Not Applicable 10 or less  11 to 25  26-100  >100
How Did You Learn About  EHSI Software?	Mailing    Magazine Ad or Article   Used Previous Version of Ours Friend or Professional Reference  Internet Search  Other
When Do You Plan To Purchase Software?	Immediately  Within 1 mo.  Within 6 mos.  Within 1 yr. Evaluating for Others   No plans, just browsing Current EHSI customer investigating other options
Type of Business	Manufacturing   Commercial/Retail  Utility   Education R&D  Consulting/Engineering   Government/Municipal    Other
What Operating System will be used with software?	Windows 95/98  Windows NT  Windows 2000 Windows XP Windows LAN  Novell LAN Linux Intranet  Other
Please Let Us Know Of Any Options or Features You'd Like to Hear More About ....