* Name:
* Street Address:
* City:
* State:
* Zip:
* Day Phone:
Evening Phone:
Cell Phone:
* Email Address:
* Type of Building: Commercial
  Residential
  Retail
  Restaurant/Bar/Night Club
  Industrial/Manufacturing Facility
  Institutional (i.e. Education, Government, etc.)
  Medical (i.e. Hospital, Clinic, etc.)
  Other (Pls. specify)
What type of Internet connection does the location have:
How would you best describe your current security needs? We are looking for a new system
  We are looking to expand our current system
  We are looking to replace our current system
What is the approximate square footage of the building? 1,000 - 2,499 sq.ft.
  2,500 - 4,999 sq.ft.
  5,000 - 9,999 sq.ft.
  10,000 - 49,999 sq.ft.
  50,000+ sq.ft.
  Not sure
When would you like to have your equipment operational by? ASAP
  1 - 2 Weeks
  2 - 4 Weeks
  1 - 2 Months
  2+ Months
  Not sure
Are you more concerned with Quality or Cost? Quality
  Cost
What is your estimated budget for this system? $2,000 - $4,999
  $5,000 - $9,999
  $10,000 - $24,999
  $25,000+
  Not sure
How secure does the network need to be? Low security
  High security
  Not sure
Do you require professional maintenance for this system? Yes
  No
  Not sure
What are your requirements? Remote Viewing
  Yes
  No
  Not sure
  Night Vision
  Yes
  No
  Not sure
  Recording
  Yes
  No
  Not sure
  PTZ (pan, tilt & zoom)
  Yes
  No
  Not sure
  Hidden
  Yes
  No
  Not sure
  Wireless
  Yes
  No
  Not sure
Where will the video surveillance cameras be located? Indoors Only
  Outdoors Only
  Both Indoors and Outdoors
  Not sure
Approximately how many surveillance cameras will you need? 8
  16
  32
OTHER SECURITY NEEDS What are the other security options you are interested in?
 
COMMENTS Any additional comments, requests, or questions?
 
How did you hear about us:
 

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