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Account Number
*look on your mailing label
Name
Organization
Address
City
State Zip
Country
Phone
Fax
Email

1. Which best describes your company's primary business? (check one)
Agriculture/Forestry/Fishing Hospitality
Communications Manufacturing
Construction Retail Trade
Delivery/Courier Service School/College/University
Finance/Insurance/Legal Transportation
Food Products Utility
Government Wholesale Trade
Health Services   Other:

2. Which best describes your job function? (check one)
Company Official Engineering/Product Development
Fleet Managment Service/Maintenance
Marketing & Sales Administration
Other

3. How many fleet vehicles does your company own or operate? (check one)
0 vehicles 51-100 vehicles
1-20 vehicles 101-200 vehicles
21-50 vehicles 201 + vehicles

4. Indicate your purchasing authority? (check all that apply)
Purchase Recommend
Authorize None of the Above
Specify All of the Above

5. Do you plan to purchase, authorize, specify, recommend any fleet products/services in the next:
3 months or less Year or more
4-6 months No spending planned
7-11 months

6. How much do you plan to allocate for any fleet products/services mentioned in question 5? ($U.S.)
$500,000 or more $50,000 - $99,999
$250,000 - $499,999 $25,000 - $49,000
$100,000 - $249,999 $24,999 or less