This Form is for Affiliate Members of LISTnet!

The purpose of this questionnaire is to gather information about the products and services that your company provides. The results of this survey will be incorporated into our LISTnet Database and will be Searchable by the business community at large. Please answer all questions, and please give us your thoughts in the space provided for general comments.

This represents an outstanding opportunity for you to provide a concise and easily accessible listing for the business community.

NOTE: You must sign up and be a member of LISTnet to create a company profile in LISTnet's Web Site. This is a benefit listing for members only. Please contact LISTnet at (631) 224-4400 to get a membership application or click on http://www.listnet.org/join.cfm to sign up. For details on additional membership benefits visit: http://www.listnet.org/membership_benefits.cfm