AIS Information Form

Request for Information

Please fill out the following information and we will respond to you as soon as possible. If you need information sooner, call us on our toll free number at 1-877-625-XESS or at 1-919-942-7801. Thank you for stopping by our web site.

Your information please…

              Name: 
 Firm/Organization: 
           Address: 
              City:  State/Province: 
        ZIP/Postal:  Country: 
         Telephone: 
               FAX: 
            E-mail:

Primary Operating Environment:

Primary application for XESS:
If other, please describe:

How many users would need to access this application?

What is your decision timeframe?

…And how may we help you?

Would you like to be added to our mailing list? Yes, please, I just don't get enough email!

Would you like a sales person to contact you? Yes, please call as soon as possible

Would you like us to mail you additional information related to your particular interest? Yes, please send information immediately.

Is there anything else?

Applied Information Systems, Inc.
121 South Estes Drive
Chapel Hill, NC 27514 USA
1-919-942-7801
1-877-625-9377
1-919-942-0793 FAX
info@appliedinfosys.biz.