I. Environmental (check ALL that apply): Indoor Outdoor Unattended Area Dirt, Dust, Air-Borne Particulants Rain/Snow Excessive Shock/Vibration Direct Sunlight (no cover) Indirect Sunlight (covered) Other

II. Flat Panel Display Size (Pro-Tech, Inc supplied): 15.1" Standard Brightness 15.1" Hi-Bright (for direct sunlight) 17.1" Standard Brightness 17.1" Hi-Bright (for direct sunlight)

III. Customer Interface (check all that apply) Touchscreen Keyboard/Trackball Credit/Debit Card Reader (MSR) Speaker Wireless Bridge Proximity Sensor Optical Scanner Webcam Phone Other:

VI. Ergonomics (check any that apply or leave blank) Normal Stand-up Height Normal Sit-down Height ADA Compliant

VII. Temperature (if known) Maximum Ambient Temp: Do not know 70 F or Less 70-80 F 80-90 F 90-100 F 100-110 F 110-120 F 120+ F Minimum Ambient Temp: Do not know 40 F or Greater 30-40 F 20-30 F 0-20 F Humidity (high, moderate or low): Do not know Low Moderate High

VIII. Requirements Quantity: 1-4 5-9 10-24 25-49 50-99 100+ Date quote is needed: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2006 2007 2008 Date kiosks are needed: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2005 2006 2007 2008 Project Stage: Info Gathering Preliminary Pilot Phase Funded Roll-out Can't Say Customer Type: End User OEM Reseller Architect Engineer Rep Distributor Software Supplier Integrator Number of literature packets to be mailed: 0 1 2 3 5 10 Preferred method of response: Email Fax Phone Snail Mail Other:

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