COVER-PRO
SM
APPLICATION
COMPUTER / TECHNOLOGY CONSULTANT SUPPLEMENT
1. Full name of the Applicant Firm:
2. Please list and provide a brief description of your pri
mary software and service applications
. (i.e. payroll, fund
transfer, education, etc…)
3. Please indicate the percentage of the
Applicant’s gr
oss annual revenue from the last fiscal period involving:
(A) (B)
Training and education: % Hardware / Software sales: %
Record management / Retrieval: % Equipment evaluation &
Package software installations: % selection: %
EDP audit: %
Minor hardware installations: % “Needs” evaluation: %
Hardware maintenance / Service: % TOTAL (B):
%
Graphics / Presentation materials: %
Hardware / Software pass thru sales
:
% (D)
(sold at cost) Computer security/Virus
TOTAL (A): % serv
ice
s: %
(C)
Electronic bulletin board / Chat
Custom software development: % room services: %
Computer:
% E-mail services: %
Sys
tem design: % Website design / Construction: %
Turnkey installations: % Content provider servic
es:
%
Hardware / Software manufacturing: %
Internet Service Provider (ISP): %
Research & development: % Internet advertising: %
TOTAL (C): % Domain name registration:
%
TOTAL (D): %
(A) % + (B) % + (C) % + (D) % =TOTAL MUST EQUAL 100
%
4. Does the Applicant provide any services othe
r than those listed in
question 3? If yes, provide details.
If any percentages are entered into Section D above, please complete questions 5 – 11.
5. Has the Applicant ever received a complaint co
ncerning interne
t services relevant to?
Libel or slander: Yes No Trademark infringement: Yes No
Invasion of privacy: Yes No Copyright infringement: Yes No
Inaccurate information: Yes No
6. How do you respond to such complaints and in what time frame?
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