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^{Data Center Account Application}

Thank you for your interest in XTEC. Answer the following questions. Please note that all questions must be completed for this form to be submitted. Following submission, you will be emailed with your login and password when they have been activated (usually within one business day).

Please provide the following contact and company information:

First Name
Last Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Fax
E-mail
URL
Resale #

To establish your account, please provide the following:

Company Name

Password

Confirm Password

Describe your company: (check one)

Manufacturer
Service Organization
End-User
What is your primary interest in establishing an account? (check one)

Tracking inventory and orders
Checking repair and parts pricing
Ordering parts and supplies
Other
What is your primary job function? (check one)

Corporate Management
Supply Chain Management
Service Management
Manufacturing
Procurement/Purchasing
Service
Other
What industry does your primary end product or service support? (check one)

Computer Hardware (incl. Servers, PCs, Laptops & Handhelds)
Displays, Printers & Other Peripherals
Communications Equipment
Avionics/Marine/Military Electronics (incl. Defense Contractors)
Government Agency
Industrial Equipment
Graphics Equipment (incl. RIPs & Wide format Printers)
Office Equipment (Copiers, Laser Printers & Fax Machines)
Instrumentation & Test Equipment
Automotive Electronics
Consumer Products
Subassemblies (Boards, Modules, Etc.)
Power Supplies
Other
I am involved in the following procurement, supply chain mgmt & other business mgmt activities: (check all that apply)

Manage the supply chain
Recommend/approve the increase or decrease in
a supplier's share of a multi-source buy
Evaluate/approve/veto sole source procurement
Evaluate/approve/veto strategic suppliers
Locate/evaluate/select products
Not involved in any procurement, supply chain
mgmt or other business mgmt activities
The approximate annual dollar value of parts and services that I buy or approve is: (check one)

$1,000,000 or more
$100,000 to $999,999
$10,000 to $99,999
Under $10,000
None

Company Name
Password
Confirm Password

Copyright © 2002 XTEC, Inc. All rights reserved. Revised: August 17, 2003

Copyright © 2002 XTEC, Inc. All rights reserved.
Revised: August 17, 2003