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Please indicate your firm's name:
Check this box if you wish to receive the results of your assessment of your Web site.
Check this box if you wish to receive a summary of the results, when available.
Please indicate your firm's Web site address:
Please indicate your e-mail address:
Please indicate your opinion about the following statements:
Once per week
Once per month
Once per quarter
Once per year
Less than once per year
The Content of your firm's Web site is updated
Less than 1 year
1-3 years
4-6 years
7-9 years
10 years or more
Your firm's Web site has existed for:
Less than 10%
11-30%
31-50%
51-70%
71-100%
The percentage of your firm's employyes who are connected to the Internet is:
The percentage of your firm's budget invested in web site development and/or maintenance is:
Your firm is based in the following region:
West
East
North
South
Other (Specify)
Your job title
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