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<table width="601" height="486" border="0" align="center" cellpadding="0" cellspacing="0" id="Table_01">
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		<td>&nbsp;</td>
		<td>&nbsp;</td>
		<td>&nbsp;</td>
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		<td>&nbsp;</td>

		<td>&nbsp;</td>
		<td rowspan="2">&nbsp;</td>
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		<td>&nbsp;</td>
		<td>&nbsp;</td>
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	<tr>
		<td colspan="2" bgcolor="#FFFFFF" style="padding-left: 15px;">
			<form action="/cgi-bin/formmail.pl" method="post">
				<input type="hidden" name="recipient" value="[email protected]">
				<input type="hidden" name="subject" value="Sionadd Questionnaire Response">
				<input type="hidden" name="redirect" value="http://www.genisign.com">
				
		  <p class="style2">Complete Survey: </p>
		  <table style="font-weight: bold;">
		  	<tr>
				<td>Name:</td><td><input type="text" name="realname"></td>
			</tr>
			<tr>
				<td>Address:</td><td><input type="text" name="address"></td>
			</tr>
			<tr>
				<td>City:</td><td><input type="text" name="city"></td>
			</tr>
			<tr>
				<td>State:</td><td><input type="text" name="state"></td>
			</tr>
			<tr>
				<td>Zip:</td><td><input type="text" name="zip"></td>
			</tr>
			<tr>
				<td>Email:</td><td><input type="text" name="email"></td>
			</tr>
			<tr>
				<td>Phone:</td><td><input type="text" name="phone"></td>
			</tr>
			
		  </table>
		  
		  <table>
			<tr>
				<td valign="top"><strong>Did  you gather what the product does?</strong></td>
				<td>	<p>
				  <select name="best_time_to_call">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			      </select>
				  <br>
				  <br>
				  Comments?
				  <input type="text" name="number_of_windows2">
				</p>
			  </td>
		  	<tr>
				<td valign="top" bgcolor="eeeeee"><strong>Is  the technology original?</strong></td>
				<td bgcolor="eeeeee"><p>
				  <select name="select">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			      </select>
				  <br>
				  <br>
				  Comments?
				  <input type="text" name="number_of_windows3">
				</p>
			  </td>
			</tr>
			<tr>
				<td valign="top"><strong>Is  the product innovative?</strong></td>
				<td><p>
				  <select name="select2">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			      </select>
				  </p>
				  <p>Comments?
				    <input type="text" name="number_of_windows4">
				  </p>
			  </td>
			</tr>
			<tr>
				<td valign="top" bgcolor="eeeeee"><strong>Do  you believe it can provide a service?</strong></td>
				<td bgcolor="eeeeee"><p>
				  <select name="select3">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			        </select>
				</p>
				  <p>Comments?
				    <input type="text" name="number_of_windows42">
				  </p>
			  </td>
			</tr>
			<tr>
				<td valign="top"><strong>What  are the most distinctive attributes that differentiate us from other offerings</strong></td>
				<td><p>
				  <select name="select4">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			        </select>
				</p>
				  <p>Comments?
				    <input type="text" name="number_of_windows43">
				  </p>
			  </td>
			</tr>
			<tr>
				<td valign="top" bgcolor="eeeeee"><strong>What  did you like most about the product?</strong></td>
				<td bgcolor="eeeeee"><p>
				  <select name="select5">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			        </select>
				</p>
				  <p>Comments?
				    <input type="text" name="number_of_windows44">
				  </p>
			  </td>
			</tr>
			<tr>
				<td valign="top"><strong>What  did you like least about the product?</strong></td>
				<td><p>
				  <select name="select6">
				    <option value="Excellent">Excellent</option>
				    <option value="Good">Good</option>
				    <option value="Average">Average</option>
				    <option value="Poor">Poor</option>
				    <option value="Very Poor">Very Poor</option>
			        </select>
				</p>
				  <p>Comments?
				    <input type="text" name="number_of_windows45">
				  </p>
			  </td>
			</tr>
			<tr bgcolor="eeeeee">
				<td valign="top"><strong>Has  an variable output of 60 volts and 5 amps giving 200 watts?</strong></td>
				<td><p>
				  <select name="select10">
                    <option value="Excellent">Excellent</option>
                    <option value="Good">Good</option>
                    <option value="Average">Average</option>
                    <option value="Poor">Poor</option>
                    <option value="Very Poor">Very Poor</option>
                  </select>
</p>
			      <p>Comments?
			        <input type="text" name="number_of_windows452">
                  </p></td>
			</tr>
			<tr>
				<td valign="top"><strong>Ability  to vary voltage over the full range?</strong></td>
				<td><p>
				  <select name="select11">
                    <option value="Excellent">Excellent</option>
                    <option value="Good">Good</option>
                    <option value="Average">Average</option>
                    <option value="Poor">Poor</option>
                    <option value="Very Poor">Very Poor</option>
                  </select>
</p>
				  <p>Comments?
				    <input type="text" name="number_of_windows453">
                  </p></td>
			</tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>The  ability to provide current limiting?</strong></td>
			  <td><p>
			    <select name="select12">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows454">
                </p></td>
		    <tr>
              <td valign="top"><strong>The  ability to vary the voltage over the full range</strong><strong>?</strong></td>
			    <td><p>
			      <select name="select13">
                    <option value="Excellent">Excellent</option>
                    <option value="Good">Good</option>
                    <option value="Average">Average</option>
                    <option value="Poor">Poor</option>
                    <option value="Very Poor">Very Poor</option>
                  </select>
</p>
			      <p>Comments?
			        <input type="text" name="number_of_windows455">
                  </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>The  fact that the device is 95-98% efficient?</strong></td>
			  <td><p>
			    <select name="select14">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows456">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>Reduced  noise held less than 10 mv?</strong></td>
			  <td><p>
			    <select name="select15">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows457">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>Can  sit in the palm of your hand?</strong></td>
			  <td><p>
			    <select name="select16">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows458">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>The  ability to program it?</strong></td>
			  <td><p>
			    <select name="select17">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows459">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>Weighs  less than a pound?</strong></td>
			  <td><p>
			    <select name="select18">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows4510">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>The  device can be stacked campus wide?</strong></td>
			  <td><p>
			    <select name="select7">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows4511">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>The  devices can be synchronized globally?</strong></td>
			  <td><p>
			    <select name="select8">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows4512">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>Single  output?</strong></td>
			  <td><p>
			    <select name="select9">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows4513">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>Provides  real-time graphics?</strong></td>
			  <td><p>
			    <select name="select19">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows4514">
                </p></td>
		    <tr>
              <td valign="top"><strong>Can  communicate across the network: Ethernet, RS232?</strong></td>
			    <td><p>
			      <select name="select20">
                    <option value="Excellent">Excellent</option>
                    <option value="Good">Good</option>
                    <option value="Average">Average</option>
                    <option value="Poor">Poor</option>
                    <option value="Very Poor">Very Poor</option>
                  </select>
</p>
			      <p>Comments?
			        <input type="text" name="number_of_windows4515">
                  </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>Meets  regulatory requirements: Time stamps, passwords and audit trails?</strong></td>
			  <td><p>
			    <select name="select21">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows4516">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>Is  the 128 bit encryption necessary for security?</strong></td>
			  <td><p>
			    <select name="select22">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows4517">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>Comes  with windows 95, vista compliant software?</strong></td>
			  <td><p>
			    <select name="select24">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
		        <p>Comments?
		          <input type="text" name="number_of_windows4519">
                </p></td>
		    </tr>
			<tr>
              <td valign="top"><strong>Can  implement enterprise wide central security and control?</strong></td>
			  <td><p>
			    <select name="select23">
                  <option value="Excellent">Excellent</option>
                  <option value="Good">Good</option>
                  <option value="Average">Average</option>
                  <option value="Poor">Poor</option>
                  <option value="Very Poor">Very Poor</option>
                </select>
</p>
			    <p>Comments?
			      <input type="text" name="number_of_windows4518">
                </p></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>What  would you price it at?</strong></td>
			  <td><input type="text" name="number_of_windows45"></td>
		    </tr>
			<tr>
              <td valign="top"><strong>Would  you like more information on the product?</strong></td>
			  <td><input type="text" name="number_of_windows46"></td>
		    </tr>
			<tr bgcolor="eeeeee">
              <td valign="top"><strong>What  is the likelihood that you would purchase the device?</strong></td>
			  <td><input type="text" name="number_of_windows47"></td>
		    </tr>
		  </table>
		  
		  <div align="center" style="padding: 8px;">
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		<td width="156" valign="top" bgcolor="#eeeeee">&nbsp;</td>
		<td>
			<img src="file:///C|/Documents and Settings/Jason Brown/My Documents/Jason's Documents/Client/THM/wsc125547822/FreeGifts/images/spacer.gif" width="1" height="99" alt=""></td>

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Anon7 - 2021