GET ON THE LIST / GIVE US YOUR FEEDBACK

REQUIRED DATA			OPTIONAL DATA
Name       (first)			I prefer to receive my email messages in HTML format (check here)
(last)
E-Mail Address			Company
Add me to your e-mail list    YES    NO			City
			State/Province	-- US -- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY -- Can -- AB BC MB NB NF NS NT ON PE PQ QC SK YT
			Zip/Postal Code

Should you have a question or comment, please type it in below.

INQUIRY PROFILE

We invite you to complete this brief inquiry profile. This data is important, as it assists us in evaluating and improving our products, services and website capabilities to better serve you. It also will allow us to tailor our offers and messages to meet your specific needs. Your information will be kept confidential. It is for ER internal-use only. We will not share this information with any outside parties.

1. I am a current Electro Rent Customer:      YES     NO (please check one)

2. I am interested in : (please check all that apply)
   Renting     Leasing     Purchasing Used Computer Products

3. I plan to rent, lease or buy: (please check one)
Now     In a few weeks     In the next 3 months     Longer than 3 months
Undecided

4. How did you learn about/find Electro Rent? (please check all that apply)

	Saw you at a tradeshow			Referral from someone outside my company
	My company has an account with ER			Online via Google search
	Yellow pages - print			Online via Yahoo search
	Yellow pages - online			Online via MSN search
	Referral from someone within my company			Online via AOL search
	Online via other			Periodical or print advertisement
	Contacted by an ER sales rep			Received an email from ElectroRent
	Received a direct mail piece from ER			Other

5. Type(s) of equipment I am/may be looking for: (please check all that apply)

	Desktops (PC)			Monitors/Flat Panel Displays
	Desktop (Apple)			Plasma Displays
	Notebooks (PC)			Printers & Plotters
	Notebooks (Apple)			Networking Products
	Servers (PC)			Wireless Products
	Servers (Sun)			Workstations
	Projection Devices			OTHER

6. The equipment is mainly for:    Business Use     Personal Use     (please check one)
NOTE: Electro Rent's rental and leasing programs are designed for businesses. Used computer purchase programs are open to businesses and individuals.

7. The equipment will be used in one or more of the following ways: (please check all that apply)

	Training classes/sessions			General office use
	Tradeshows			Seasonal/temporary staffing situations
	Meetings or special events			Mobile computing
	System/software testing and/or development			Want to try the equipment before I buy it
	Consulting applications			Other

8. If renting, I expect to rent computer and/or presentation products: (please check one)
    Only this once     2 - 4 times per year     More than 4 times per year    

9. What are the most important reasons why you are a customer of or are considering becoming a customer of ER? (please check all that apply)

	I need a company that can handle my rental/leasing needs on a nationwide basis.
	ER has been around a long time, so I trust that they will be here in the future when I need them.
	ER has a large inventory of high quality computer and presentation products.
	ER has the lowest price.
	ER offers one or more valuable additional services, besides the equipment itself, that I find useful.
	Other

10. Is there someone you know that might benefit from our rental, leasing or used equipment sales programs?

Which one (check all that apply):    Renting     Leasing     Purchasing Used Computer Products