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Last Name
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Title
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Company
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Department
Business Phone
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Email Address
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State
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Military Americas
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Country
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Canada
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* Is your direct employer a government agency/institution or a private company selling products/services to the government?
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Agency/Institution
Private Company
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Please indicate your branch of government or business activity:
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A - Federal Government
B - State Government
C - County Government
D - Municipal Government
E - Special District, Public Utility
Y - Private Sector - Systems/Software/Network Integrator
Z - Private Sector - Suppliers to Government
X - Other
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Which category best describes your job function / classification?
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A - Elected Official
B - Agency Management (Commissioner/Director/Agency Manager/Department Manager)
C - Program Management/Project Management
D - First Responder (Police/Fire Chiefs, EMS Management)
E - Emergency Operations Center Director/Manager
F - Chief Information/Technology Officer
G - Security (Cyber Security and Physical Security)
X - Other
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What is the primary function of your agency / department?
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01 - Department of Homeland Security (FEMA, TSA, Border & Customs)
02 - Department of Justice
03 - Department of Defense
04 - Law Enforcement
05 - Fire/Emergency Services/911
06 - Emergency Operations Center
07 - National Guard
08 - Elected Officials - Legislative/Admin/Staff
09 - Telecom/Information Services/Public Utility
10 - Transportation (Port, Airport, Terminal Rail, Transit Hub)
12 - Public Health, Housing, Human Services, & Hospitals (RHIOs)
15 - Administration/Finance/General Services
16 - Environmental Protection
17 - Non-Governmental Organizations (Red Cross, Salvation Army)
20 - Private Sector - Suppliers to Government (Systems Integrators, Consultants)
99 - Other
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What area of technology are you most involved with?
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01 - Application Development
02 - Web Development/Web Portal/Internet
03 - Cyber Security/Physical Security
04 - Telecommunications/Network Management
05 - Mainframe Operations/Support
06 - Desktop/Laptop/Server Support or Operations
07 - IT Procurement
99 - Other
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