Name :
Company:
Address:
Address:
City : State/Prov:
Country: Zip/Postal Code:

Voice Telephone: Fax:

Your Email address:

Gender: Male Female
Age: 0-18 18-25 26-35 36-45 46-55 56+

How long have you had a computer in years? 0-1 2-3 4-5 5+

What type of computer do you have?

Intel Based, x86,MSDOS/WINDOWS
Apple Based, MAC, PowerMAC
RISC Based, Sun, HP PA-RISC
Other, not listed

What is your primary Operating System on your computer?

DOS (MicroSoft, IBM or look a like)
Apple MAC OS
MicroSoft Windows 3.x
MicroSoft Windows 95
MicroSoft Windows NT
IBM OS2/WARP
Unix/Xenix
Linux
Other, not listed

How do you access the Coast to Coast Archives?

Using national online service like: AOL/Prodigy/CompuServe
Using a national internet service provider like: NETCOM or PSINET
Using a regional internet service provider
Using a local internet service provider