RETAILERS

Please fill out the following qualification form:

• Required Information  
•Name of Company:
•Your Name:
•Position:
•Address:
•City:
•State:
•Zip:
•Country:
•Phone:
Fax:
•E-mail:
•Company Website:
•Year Established:
Number of stores:
If Over 100 how many?:
•How many new store openings in 2009?
•Number of employees:
•Yearly sales revenue in millions:
•Online revenue : 
•Type of Retailer : 
If other, please specify:
•Regions served: [select all that apply]:  Regional
National
International
Global (including National)
•Do you work with vendor reps or agencies to discover new vendors?
  Yes 
No
•Would it be beneficial for them to attend RetailVision?
  Yes 
No
If Yes, Why?
Please identify the product category(ies) that are relevant to your position. (Please note that your definition of the product categories may differ. The product categories are listed as Everything Channel defines the groups.)
•Accessories: 
Batteries Luggage & Cases
Broadband Media (blank cd’s, dvd’s, etc.)
Cables Media Storage (Jewel Cases, Racks, etc.)
Card Scanner Mice
CD Labels & Label Makers Microphones
Cell Phone/PDA Accessories Mobile Phone Accessories
Cleaning Supplies Mouse Pads
Consumables MP3 Accessories
Cooling Systems Office Furniture
Digital Camera Accessories Office Suppliers
Digital Music Systems Notebook Accessories
Flash Card Readers Paper & Ink
Furniture PC Camera Accessories/Controllers
Headphones Power Adapter
Ink Cartridges Remote Controls
Input Devices Security Products (Locks/Alarms)
Joysticks Shredders
Keyboards Surge Protectors
KVM Switches Surveillance – Home Security
•Consumer Electronics: 
Console Games (Xbox, Wii, Playstation, etc.) LCD TV’s
Digital Frames Plasma TV’s
Hardware Projection TV’s
Home Audio Projectors
Home Theater TV Mounts
•Hardware: 
All-in-One (psc) Network Appliances
Apple Products Networking
Components PC Cases
Consumer Electronics – Audio PC Modifications
Consumer Electronics – Vision PDA’s
CPU’s Portable Displays
Desktop Computers Portable DVD Players
Digital Video Recorder Power Supply
Faxes Printers
GPS Refurbished Goods
Hard Drives Scanners
Laptops Tablet PCs
Media Centers/Media PC UPS
Monitors Wireless Networking
Motherboards  
•Peripherals: 
CD-R/CD-RW Drives PC Cameras
Cell Phones Removable Drives
Digital Cameras Routers
DVD Optical Drives
DVD Drives Sound Cards
Flash Memory Speakers
Graphic Cards Storage
Internet Appliances (Sling Box, VOIP, Remote Security) Switches
Key Drives Thumb Drives
Memory Thumb Drive Duplicators
Mobile Peripherals USB Devices
Modems Video Cards
MP3/MP4 Players Web Cams
Network Surveillance Cameras  
•Services: 
Gift Cards VOIP
Install Repairs Warranty
Sourcing (Direct/Store/Brand) Technical/Computer Support
•Software: 
Business Software Operating Systems
Edutainment Software Productivity/Utility Software
Entertainment Software  
Please select your product category interest by preference according to the definitions above:
•First Preference: 
  Please check here if this is the ONLY category that you buy for.
•Second Preference: 
•Third Preference: 
Please list 3 topics you would like to hear more about in a content session:
1.
2.
3.