Rapid Response Form
First Name:
Last Name:
Company Name:
State:
AL
AK
AR
AZ
CA
CO
CT
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
Phone:
email:
How many years in business:
Less than 2 years
2 years - 5 years
5 years - 10 years
10 years or longer
Services you provide in your facility:
Check all that apply.
Video editing
Internet
Special effects
Mobile production
Audio
DVD
Film to tape transfer
HDTV
Graphic design
Other
Animation
Are you planning to acquire equipment:
yes
no
Equipment planning to acquire:*
Please choose one
Non-linear editing
Audio
Special effects
Broadcast
Camera
Production
Mobile
Networking
Computer workstations
Furniture
Office equipment
Other
Dollar amount of anticipated acquisition:*
Under 50K
50K-100K
100K-250K
250K-500K
500K +
Please choose one
When do you anticipate next equipment acquisition:*
Within next 60 days
Within next 3 months
Within next 6 months
6 months and longer
Please choose one
How have you financed previous equipment acquisitions:*
Leasing
Cashflow
Bank loans
Other
Please choose one
How did you hear about NAFC :
Magazine ad
Word of mouth
Vendor referral
Other
Please choose one