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Hospital/Nursing Home Personnel (bed count): # of Beds (Enter 'N' if unknown)
Select your Job Function President/C-level Manager VP Marketing/Sales/Operations/Business Development VP Engineering/Research/Technology Manager/Director - Marketing/Sales/Operations/Business Development Manager/Director - Engineering/Research/Technology Engineer/Researcher/Scientist Business/Sales Staff Educator Professional Services/Consultant Other (please specify) Please specify for Other:
Select Number of Employees Less than 50 50-99 100-499 500-999 1,000-4,999 5,000-9,999 Greater than 10,000
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Hospital/Nursing Home Personnel: Hospital/Nursing Home Personnel: cont. Administrator Dir Cardiology CEO Dir OR COO Dir Emer Room Executive VP Dir Amb Care VP/Asst Adm-General Dir Intensive Care VP/Asst Adm Clinical Svc Dir Respiratory Care VP/Asst Adm Financial Svc Nursing Home Adm VP/Asst Adm Mktg/Plng/PR Chief Accountant VP/Asst Adm Operations Other Exec (please specify) VP/Asst Adm Info Sys VP/Asst Adm Facilities Health System Executives: VP/Asst Adm Mgd Care CEO VP/Asst Adm HR COO CFO CFO CIO CPO/Matls Mgr CMIO/Chief Med Info Officer Dir Mktg/Plng/PR CPO/Matls Mgr Dir Const/Design Med Recs Admin Board Mbrs Info Syst Mgr Other (please specify) Mgd Care Admin Risk Mgmt/Compl Dir Other Health Care Organization Personnel: Qual/Pt Safety Dir HMOs/PPOs/Mgd Care/Insur Firm Patient Relations Dir Med Clinic/Group Practice Util Review Dir Surg/Emer/AmbCtr/Home Hlth Dir Communications Benefit Planner/Coalitions Dir HR Consultants Dir Mktg/Plng/ PR State/Govt Org Dir Security Grp Purch Org Dir Telecommun Mfg Equip/Svcs CMO/Med Dir/Chief Staff Schools/Library Chief Pharmacist Acctg/Investment/Law Firm CNO/Dir Nursing Svc Allied Hlth Care Medical Imaging Mgmt Other (please specify) Dir Lab Svc
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What stage of flight training have you reached? (select only one) Still considering Completed my solo cross-country Looking for a CFI/flight school Earned my private pilot certificate Had my first flight Other (please specify) Completed my first solo What is your highest aspiration? (select only one) Recreational Professional Pilot Business No aspiration at present time CFI Your Age: (select only one) <16 54-67 17-24 68-81 25-39 81+ 40-53
Still considering Completed my solo cross-country Looking for a CFI/flight school Earned my private pilot certificate Had my first flight Other (please specify) Completed my first solo
Recreational Professional Pilot Business No aspiration at present time CFI
<16 54-67 17-24 68-81 25-39 81+ 40-53
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Which of the following best describes your industry? (select only one) Agriculture Healthcare Service Provider Apparel Healthcare Banking Hospital Biotech Insurance Chemical Manufacturing Communication Media Construction Not for Profit Consulting Pharmaceutical Education Retail Electronics Shipping Energy Technology Engineering Telecommunications Entertainment Transportation Environmental Utilities Finance Other (please specify) Food and Beverage Which of the following is closest to your job function? (select only one) President/C-level Manager Systems Engineering Chief Information Officer, Chief Technology Officer Business/Sales Staff VP Marketing/Sales/Operations/Business Development Network Systems Administrator VP Engineering/Research/Technology Professional Services/Consultant IT (Director/Manager) Other (please specify) Manager/Director - Marketing/Sales/Operations/Business Development What is the number of employees in your entire organization? (select only one) less than 50 1,000-4,999 50-99 5,000-9,999 100-499 10,000-19,999 500-999 20,000+ What best matches your purchasing timeframe? (select only one) 0 - 3 months 7 - 12 months 4 - 6 months Not sure
Agriculture Healthcare Service Provider Apparel Healthcare Banking Hospital Biotech Insurance Chemical Manufacturing Communication Media Construction Not for Profit Consulting Pharmaceutical Education Retail Electronics Shipping Energy Technology Engineering Telecommunications Entertainment Transportation Environmental Utilities Finance Other (please specify) Food and Beverage
President/C-level Manager Systems Engineering Chief Information Officer, Chief Technology Officer Business/Sales Staff VP Marketing/Sales/Operations/Business Development Network Systems Administrator VP Engineering/Research/Technology Professional Services/Consultant IT (Director/Manager) Other (please specify) Manager/Director - Marketing/Sales/Operations/Business Development
less than 50 1,000-4,999 50-99 5,000-9,999 100-499 10,000-19,999 500-999 20,000+
0 - 3 months 7 - 12 months 4 - 6 months Not sure