Please complete the following form, providing as much detail as you can. This will help us either prepare a bid for your system now or give us information that will become the basis for a further exchange of ideas regarding the system.

Due to the information needed, please either email, fax, or mail us the following information.

DeRubertis Software Systems, Inc.
109 Main Street
Windermere, FL 34786
800-411-7213
407-909-0887
fax: 407-909-0863
Email: dssincpd@aol.com

1. A narrative explaining an overview of what you want the system to accomplish.
2. The flow of information into the new system including: Is the data coming from an existing system or are we starting from scratch. If existing, does the existing system have a provision to write an export file? If so, please provide a sample page.
3. If new, please indicate the pieces of information that you will be collecting for each module (e.g. field names).
4. The approximate number of records you anticipate that the system will need to handle. (This will determine if we have to back Access up with SQL Server, etc.).
5. Layouts of all output reports you would like to have the system produce.
6. The type of operating system you plan to use e.g. Windows 95, 98, NT, 2000, etc.
7. If networked, how many workstations.
8. Does the new system need to write an export file. If so, to where.
9. Does the new system need to be multi-lingual.
10. What version of Access do you intend to use.

We will get back to you within a day or so of receiving your information. Thank you for your interest in DeRubertis Software Systems, Inc.