Request Info

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="2" width=210 BGCOLOR="#000000" TEXT="#F7F7FF"> <bR> <div> <B><IMG SRC="/images/05ca9640.gif" border=0 width="169" height="100" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <div> <B>1-800-829-7978</B></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Line Cards</B></div> <div> <A HREF="newengland.htm" TARGET="_top" TITLE="New England"><U><B>New England</B></U></A></div> <div> <A HREF="newyork.htm" TARGET="_top" TITLE="Upstate NY"><U><B>Upstate New York</B></U></A></div> <div> <A HREF="florida.htm" TARGET="_top" TITLE="Florida"><U><B>Florida</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="staff.htm" TARGET="_top" TITLE="Sales Staff"><U><B>Sales Staff</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="inforqst.htm" TARGET="_top" TITLE="Request Info"><U><B>Information Request</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="featured.htm" TARGET="_top" TITLE="Featured Products"><U><B>Featured Products</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="news.htm" TARGET="_top" TITLE="News"><U><B>Electronics News</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="links.htm" TARGET="_top" TITLE="Useful Links"><U><B>Useful Links</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="feedback.htm" TARGET="_top" TITLE="Feedback"><U><B>Website Feedback</B></U></A></div> <bR> <div> <B><IMG SRC="/images/0570e0e0.gif" border=0 width="14" height="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><A HREF="http://www.mcm-inc.net/htdig/common/search.html" TARGET="_top" TITLE="http://www.mcm-inc.net/htdig/common/sear"><U><B>Search Site</B></U></A></div> </td> <td valign="top" colspan=2 height=85 BGCOLOR="#000000" TEXT="#F7F7FF"> <div> <FONT SIZE="5" COLOR="#0000FF" FACE="Copperplate Gothic Bold" ><B>Microwave Component Marketing</B></FONT><FONT SIZE="5" COLOR="#00FF00" FACE="Copperplate Gothic Bold" ><B> </B></FONT><FONT SIZE="1" COLOR="#FFFF00" FACE="Arial" ><B>|</B></FONT><FONT SIZE="1" COLOR="#FFCC99" FACE="Arial" ><B>  </B></FONT><B> </B><A HREF="index.htm" TARGET="_top" TITLE="Microwave Component Marketing"><U><B>home</B></U></A></div> <div> <A HREF="about.htm" TARGET="_top" TITLE="Products Services "><U>Products & Services </U></A>   |   <B>Request Info</B>   |   <A HREF="staff.htm" TARGET="_top" TITLE="Sales Staff"><U>Sales Staff</U></A>   |   <A HREF="news.htm" TARGET="_top" TITLE="News"><U>News</U></A>   |   <A HREF="links.htm" TARGET="_top" TITLE="Useful Links"><U>Useful Links</U></A>   |   <A HREF="feedback.htm" TARGET="_top" TITLE="Feedback"><U>Feedback</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" height=395 colspan=2 BGCOLOR="#00FFFF" TEXT="#080000"> <div>  <Form method=post action="http://www.response-o-matic.com/cgi-bin/rom.pl" method="POST"> <INPUT TYPE="hidden" NAME="your_email_address" VALUE="cmjatmcm@aol.com"> <INPUT TYPE="hidden" NAME="your_name" VALUE="MCM Sales Staff"> <INPUT TYPE="hidden" NAME="email_subject_line" VALUE="Web site info request"> <INPUT TYPE="hidden" NAME="required_fields" VALUE="your_email_address"> <INPUT TYPE="hidden" NAME="thank_you_title" VALUE="Microwave Component Marketing, Inc."> <INPUT TYPE="hidden" NAME="return_link_url" VALUE="http://www.mcm-inc.net/thanks.htm"> <INPUT TYPE="hidden" NAME="return_link_name" VALUE="Back to Microwave Component Marketing"> <INPUT TYPE="hidden" NAME="background_color" VALUE="#000000"> <INPUT TYPE="hidden" NAME="text_color" VALUE="#000000"> <INPUT TYPE="hidden" NAME="link_color" VALUE="#000080"> <INPUT TYPE="hidden" NAME="visited_link_color" VALUE="#FF00FF"> <INPUT TYPE="hidden" NAME="active_link_color" VALUE="#000080"> <TABLE bgColor="#FFFFC0" Border=0 CELLSPACING=0 CELLPADDING=3> <TR> <TD> <Center> <Font color="#000000"> <H1> Information Request Form </H1> <H2> Microwave Component Marketing, Inc. </H2> </Center> <P> Thank you for your interest in MCM's line of products and services. Please complete the form and send it to us. We will contact you as quickly as possible to discuss solutions for your application(s). Items marked with an asterisk <Font color="#FF0000">*</font> are required. </P> </TD> </TR> <TR> <TD> <TABLE CELLSPACING=5 BORDER=0> <TR><TD bgcolor="#FFFFC0" ROWSPAN=7> </TD><TD> <H2> Section 1 </H2></TD></TR> <TR> <TH align=left valign=top class=q> <a name=InfoType></a>1.1 What type(s) of products or services do you require? </TH> </TR> <TR> <TD> <TABLE CELLSPACING=0> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Cellular antennas">Cellular antennas </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="GPS antennas">GPS antennas </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Microwave antennas">Microwave antennas </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Antenna positioners">Antenna positioners, tracking systems </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Radomes">Radomes </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Cables">Cables, connectors, assemblies </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Waveguides">Waveguides </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Couplers">Couplers, dividers, feeds, switches </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Filters">Filters </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Crystals">Crystals </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Freq. sources">Frequency sources </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Mixers">Mixers, VCOs, detectors, limiters </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Power amps">Power amplifiers </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="LNAs">Low-noise amplifiers </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Freq. converters">Upconverters, downconverters </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Tx/Rx">Transmitters, receivers </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="TLM systems">Telemetry subsystems </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Instrumentation">Instrumentation </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Power supplies">Power supplies, batteries </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="PCB design">Printed circuit card design/production </TD> </TR> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Eng. services">Engineering services </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=CHECKBOX name=InfoType value="Other">Other </TD> </TR> </TABLE> </TD> </TR> <TR> <TH align=left valign=top class=q> <a name="Application"></a>1.2 Please briefly describe your application <FONT color="#FF0000" id=redText> * </FONT> <font color="#000000"></TH> </TR> <TR> <TD> <TEXTAREA class=KB NAME="Application" COLS=50 ROWS=5 WRAP=VIRTUAL></TEXTAREA><BR> </TD> </TR> <TR> <TH align=left valign=top class=q> <a name=InfoFormat></a>1.3 Please indicate the type of information package you would like to receive: </TH> </TR> <TR> <TD> <TABLE CELLSPACING=0> <TR> <TD ALIGN=Left> <Input TYPE=CHECKBOX name=InfoFormat value="Product Information">Product Information<BR> <Input TYPE=CHECKBOX name=InfoFormat value="Price quotation">Price Quotation<BR> <Input TYPE=CHECKBOX name=InfoFormat value="Company Information">Company Information<BR> <Input TYPE=CHECKBOX name=InfoFormat value=Other>Other <I> </I><INPUT class=KB TYPE=TEXT NAME=CAS1Q3A4 SIZE=20 MAXLENGTH=100><BR> </TD> </TR> </TABLE> </TD> </TR> </TABLE> </TD> </TR> <TR> <TD> <TABLE CELLSPACING=5 BORDER=0> <TR><TD> <H2> Section 2 </H2></TD></TR> <TR> <TH align=left valign=top class=q> <a name=InfoMethod></a>2.1 How would you like to receive this information? </TH> </TR> <TR> <TD> <TABLE border=1 CELLSPACING=0> <TR ALIGN=CENTER> <TD> By Email </TD> <TD> By Regular Mail </TD> <TD> By Fax </TD> <TD> Call me </TD> <TD> Personal visit </TD> </TR> <TR> <TD ALIGN=CENTER> <Input TYPE=RADIO name=InfoMethod value="Email"> </TD> <TD ALIGN=CENTER> <Input TYPE=RADIO name=InfoMethod value="Regular Mail"> </TD> <TD ALIGN=CENTER> <Input TYPE=RADIO name=InfoMethod value="Fax"> </TD> <TD ALIGN=CENTER> <Input TYPE=RADIO name=InfoMethod value="Call me"> </TD> <TD ALIGN=CENTER> <Input TYPE=RADIO name=InfoMethod value="Visit"> </TD> </TR> </TABLE> </TD> </TR> <TR> <TH align=left valign=top class=q> <a name=ContactWhen></a>2.2 What days and times are best to contact you? </TH> </TR> <TR> <TD> <INPUT class=KB TYPE="TEXT" NAME="ContactWhen" SIZE=25 MAXLENGTH=200 VALUE=""><BR> </TD> </TR> <TR> <TH align=left valign=top class=q> <a name=Purchase></a>2.3 How soon will you make a decision to purchase? </TH> </TR> <TR> <TD> <TABLE CELLSPACING=0> <TR> <TD ALIGN=Left> <Input TYPE=RADIO name=Purchase value="Immediately">Immediately<BR> <Input TYPE=RADIO name=Purchase value="3-6 months">3-6 months<BR> <Input TYPE=RADIO name=Purchase value="7-12 months">7-12 months<BR> <Input TYPE=RADIO name=Purchase value="A year or more">A year or more<BR> </TD> </TR> </TABLE> </TD> </TR> </TABLE> </TD> </TR> <TR> <TD> <TABLE CELLSPACING=5 BORDER=0> <TR><TD> <H2> Section 3 </H2></TD></TR> <TR> <TH align=left valign=top class=q> <a name=Contact></a>3.1 Please provide us with your contact information: </TH> </TR> <TR> <TD> <TABLE CellSpacing=0 CELLPADDING=0> <TR><TD Align=right vAlign=top>Name</font> <Font color="#FF0000">*</font><font color="#000000">:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactName" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Title:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactTitle" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Company</font><Font color="#FF0000">*</font><font color="#000000">: </TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactCompany" SIZE=35 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Address</font><Font color="#FF0000">*</font><font color="#000000">:</TD><TD> <p class=KB> <TEXTAREA class=KB NAME=ContactAddress COLS=30 ROWS=3 WRAP=VIRTUAL></TEXTAREA> </p></TD></TR> <TR><TD Align=right vAlign=top>City</font><Font color="#FF0000">*</font><font color="#000000">:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactCity" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>State/province</font><Font color="#FF0000">*</font><font color="#000000">: </TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactState" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Country</font><Font color="#FF0000">*</font><font color="#000000">:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactCountry" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Post/zip code:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactZip" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Phone</font><Font color="#FF0000">*</font><font color="#000000">:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactPhone" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Email:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactEmail" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> <TR><TD Align=right vAlign=top>Company Web Site:</TD><TD><INPUT class=KB TYPE="TEXT" NAME="ContactWebsite" SIZE=25 MAXLENGTH=200 VALUE=""> </TD></TR> </TABLE> </TD> </TR> <TR> <TH align=left valign=top class=q> <a name=MailList></a>3.2 Would you like to be added to our mailing list? </TH> </TR> <TR> <TD> <TABLE CELLSPACING=0> <TR> <TD ALIGN=Left VALIGN=top> <Input TYPE=RADIO name=MailList value="Yes">Yes </TD> <TD ALIGN=Left VALIGN=top> <Input TYPE=RADIO name=MailList value="No">No </TD> </TR> </TABLE> </TD> </TR> </TABLE> </TD> </TR> <TR> </font> <TD Align=center>  <br><input type="submit" NAME ="Submit" value="Submit"> <input type=reset value="Reset Form"><br>  </TD> </TR> </TABLE> </Form>  </div> </td> </tr></table></body>