QuickPrototypes.com - Get Started

Please supply some information about yourself and your proposed project.

All fields labeled in bold are required.

Company or Business Name:
Address:
(address 2):
City:	State: Zip:
Contact Information
Name:	First Last
Title:
Email:
Phone:	( ) - ext
Fax:	( ) -
Best Time To Call:	Daytime Evening/Weekend
Business Type/Industry:
Products/Services offered:
Web Site Address (if applicable):
Number of Employees:
Annual budget for Information Technology:	$
Proposed Project Please don't give any more details than you are comfortable with. Before work on the prototype begins, we will sign a nondisclosure agreement.
Project Name:
Description:
Brief Requirements Discussion (240 chars):
Additional Requirements Discussion (240 chars):
Estimated number of users:
Target operating system (select most relevant or interesting if multiple apply):	Palm OS Windows 95/98/NT/2000/XP Unix/Linux MacIntosh Other:
User/Network Configuration (select most relevant if multiple apply):	Stand-alone Local Area Network Internet/Intranet Remote/Field Hand-Held or Radio Frequency Other:
Project type:	Prototype/Proof-Of-Concept Application - New development Modifications to an existing system
Desired completion date (mm/dd/yyyy):

---

Please indicate how much your business wants to pay for this project. You are not bound by any of your responses here. We will work with you on drafting a contract as the next step.

Thanks.

Price Component	Amount I want to pay (US dollars)	Per
Initial development/deployment fee	$	one-time
Recurring maintenance fee	$	month
Other, please describe	$	per

---

QuickPrototypes.com Info

How did you find out about QuickPrototypes.com?
Register for the Palm OS prototype promotion (details):	Yes No

---

Thank you for filling out this form.

Comments or questions? Please contact us.