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name="demo63019" type="text" value="" id="id598" maxlength="48" size="48"/></p></div><div id="disp63020" style="display:none;"><p id="p333" class="drg-element-type-cms-content drg-element-sub-type-category-3"><span class="questionlabel "><label for="id333">Confirm Alternate E-Mail Address <font color="red">*</font></label> </span><input class="drg-field-normal" name="demo63020" type="text" value="" id="id333" maxlength="48" size="48"/></p></div><p id="p1" class="drg-element-type-standard-field drg-element-sub-type-fieldname-FIRSTNAME addresslabel"><span class="questionlabel "><label for="id1">First Name <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63021" type="text" value="" id="id1" maxlength="40" size="40"/></p><p id="p2" class="drg-element-type-standard-field drg-element-sub-type-fieldname-LASTNAME addresslabel"><span class="questionlabel "><label for="id2">Last Name <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63022" type="text" value="" id="id2" maxlength="40" size="40"/></p><p id="p10" class="drg-element-type-standard-field drg-element-sub-type-fieldname-TITLE addresslabel"><span class="questionlabel "><label for="id10">Title <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63023" type="text" value="" id="id10" maxlength="40" size="40"/></p><p id="p3" class="drg-element-type-standard-field drg-element-sub-type-fieldname-COMPANY addresslabel"><span class="questionlabel "><label for="id3">Company/Agency <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63024" type="text" value="" id="id3" maxlength="40" size="40"/></p></div> <div class="span6" id="content3"><p id="p4" class="drg-element-type-standard-field drg-element-sub-type-fieldname-ADDRESS addresslabel"><span class="questionlabel "><label for="id4">Address <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63026" type="text" value="" id="id4" maxlength="255" size="255"/></p><p id="p5" class="drg-element-type-standard-field drg-element-sub-type-fieldname-DEPARTMENT addresslabel"><span class="questionlabel "><label for="id5">Address 2 <small><small>(optional)</small></small></label> </span><input class="drg-field-address-normal" name="demo63027" type="text" value="" id="id5" maxlength="255" size="255"/></p><p id="p6" class="drg-element-type-standard-field drg-element-sub-type-fieldname-CITY addresslabel"><span class="questionlabel "><label for="id6">City <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63028" type="text" value="" id="id6" maxlength="100" size="100"/></p><span class="spanc8 drg-element-type-standard-field drg-element-sub-type-fieldname-STATE"><p id="p8" class="drg-element-type-standard-field drg-element-sub-type-fieldname-STATE addresslabel"><span class="questionlabel "><label for="id8">State <font color="red">*</font></label> </span><select name="demo63029" id="id8"><option value="">Select One</option><option value="1">ALABAMA</option><option value="2">ALASKA</option><option value="3">ARIZONA</option><option value="4">ARKANSAS</option><option value="5">CALIFORNIA</option><option value="6">COLORADO</option><option value="7">CONNECTICUT</option><option value="8">DELAWARE</option><option value="9">DISTRICT OF COLUMBIA</option><option value="10">FLORIDA</option><option value="11">GEORGIA</option><option value="12">HAWAII</option><option value="13">IDAHO</option><option value="14">ILLINOIS</option><option value="15">INDIANA</option><option value="16">IOWA</option><option value="17">KANSAS</option><option value="18">KENTUCKY</option><option value="19">LOUISIANA</option><option value="20">MAINE</option><option value="21">MARYLAND</option><option value="22">MASSACHUSETTS</option><option value="23">MICHIGAN</option><option value="24">MINNESOTA</option><option value="25">MISSISSIPPI</option><option value="26">MISSOURI</option><option value="27">MONTANA</option><option value="28">NEBRASKA</option><option value="29">NEVADA</option><option value="30">NEW HAMPSHIRE</option><option value="31">NEW JERSEY</option><option value="32">NEW MEXICO</option><option value="33">NEW YORK</option><option value="34">NORTH CAROLINA</option><option value="35">NORTH DAKOTA</option><option value="36">OHIO</option><option value="37">OKLAHOMA</option><option value="38">OREGON</option><option value="39">PENNSYLVANIA</option><option value="40">RHODE ISLAND</option><option value="41">SOUTH CAROLINA</option><option value="42">SOUTH DAKOTA</option><option value="43">TENNESSEE</option><option value="44">TEXAS</option><option value="45">UTAH</option><option value="46">VERMONT</option><option value="47">VIRGIN ISLANDS</option><option value="48">VIRGINIA</option><option value="49">WASHINGTON</option><option value="50">WEST VIRGINIA</option><option value="51">WISCONSIN</option><option value="52">WYOMING</option><option value="53">American Samoa</option><option value="54">Guam</option><option value="56">Micronesia (Federated States of)</option><option value="58">Puerto Rico</option><option value="59">U.S. Minor Outlying Islands</option><option value="60">NORTHERN MARIANA ISLANDS</option><option value="61">Armed Forces Africa</option><option value="62">Armed Forces Americas AA (except Canada)</option><option value="63">Armed Forces Canada</option><option value="64">Armed Forces Europe AE</option><option value="65">Armed Forces Middle East AE</option><option value="66">Armed Forces Pacific AP</option></select><p></span><p id="p9" class="drg-element-type-standard-field drg-element-sub-type-fieldname-ZIP addresslabel"><span class="questionlabel "><label for="id9">Zip <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63030" type="text" value="" id="id9" maxlength="9" size="9"/></p><p id="p11" class="drg-element-type-standard-field drg-element-sub-type-fieldname-PHONE addresslabel"><span class="questionlabel "><label for="id11">Direct Phone <font color="red">*</font></label> </span><input class="drg-field-address-normal" name="demo63031" type="text" value="" id="id11" maxlength="32" size="32"/></p><p id="p124" class="drg-element-type-standard-field drg-element-sub-type-fieldname-PHONE_MOBILE addresslabel"><span class="questionlabel "><label for="id124">Mobile Phone</label> </span><input class="drg-field-address-normal" name="demo63302" type="text" value="" id="id124" maxlength="20" size="20"/></p></div> </div> <div class="row-fluid"> <div class="span12" id="content4"><div class="subheader">Profile</div><span class="spanc533 drg-element-type-demographic drg-element-sub-type-type-1"><p id="p533" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id533">Please indicate your primary branch of government or business activity (Choose one): <font color="red">*</font></label> </span><select name="demo63508" id="id533"><option value="">Select...</option><optgroup class="select_response_subheader" label="Federal Civilian"></optgroup><option value="1305">    Executive Office of the President (incl. OMB, OSTP)</option><option value="1306">    Agriculture (USDA)</option><option value="1307">    Commerce (DOC)</option><option value="1302">    Dept of Defense /Intelligence</option><option value="1308">    Education (ED)</option><option value="1309">    Energy (DOE)</option><option value="1310">    Health and Human Services (HHS)</option><option value="1311">    Homeland Security (DHS)</option><option value="1312">    Housing and Urban Development (HUD)</option><option value="1314">    Justice (DOJ)</option><option value="1315">    Labor (DOL)</option><option value="1316">    State (DOS)</option><option value="1313">    Interior (DOI)</option><option value="1318">    Treasury</option><option value="1317">    Transportation (DOT)</option><option value="1319">    Veterans Affairs (VA)</option><option value="78421">    Consumer Finance Protection Bureau</option><option value="1320">    EPA</option><option value="78420">    Federal Communications Commission</option><option value="78419">    Federal Trade Commission</option><option value="1321">    GSA</option><option value="78427">    Judicial</option><option value="1328">    Legislative</option><option value="78426">    Merit Systems Protection Board</option><option value="1322">    NASA</option><option value="78425">    National Archives and Records Administration</option><option value="1323">    NSF</option><option value="78424">    Office of Personnel Management</option><option value="1324">    SBA</option><option value="1325">    SSA</option><option value="78418">    U.S. Agency for International Development</option><option value="1326">    USPS</option><option value="1330">    Other Federal Government</option><optgroup class="select_response_subheader" label="Department of Defense"></optgroup><option value="78417">    Defense Contract Management Agency</option><option value="1298">    Air Force</option><option value="1299">    Army</option><option value="1300">    Navy</option><option value="1301">    Marine Corps</option><option value="78962">    Coast Guard</option><option value="78961">    Army Corps of Engineers</option><option value="78960">    Defense Health Agency (DHA)</option><option value="78963">    Defense Information Systems Agency (DISA)</option><option value="1303">    Defense Agencies</option><optgroup class="select_response_subheader" label="Intelligence Agencies (incl ODNI, CIA, NSA)"></optgroup><option value="1304">Intelligence Agencies (incl ODNI, CIA, NSA)</option><optgroup class="select_response_subheader" label="State and Local Government IT"></optgroup><option value="79045">    State Government</option><option value="79046">    State/Local Gov Employee/Embed Contractor</option><option value="79047">    County Government</option><option value="79048">    Education</option><optgroup class="select_response_subheader" label="Industry Supporting Government IT"></optgroup><option value="79049">    Systems Integrator</option><option value="79050">    Fed Gov Employee.Embed Contractor</option><optgroup class="select_response_subheader" label="Non-Profit/NGO/Educational Organization"></optgroup><option value="78422">    Non-Profit/NGO/Educational Organization</option></select></p></span><span class="spanc535 drg-element-type-demographic drg-element-sub-type-type-1"><p id="p535" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id535"><strong>What is your job function? (choose one)</strong> <font color="red">*</font></label> </span><select name="demo63179" id="id535"><option value="">Select...</option><option value="1335">C-Level Management/Command</option><option value="1338">Executive/Senior Management</option><option value="1336">Executive/Senior IT Management</option><option value="1339">Program Management</option><option value="1340">Project Management</option><option value="1337">IT Staff/Management</option></select></p></span><span class="spanc538 drg-element-type-demographic drg-element-sub-type-type-2"><p id="p538" class="drg-element-type-demographic drg-element-sub-type-type-2"><span class="questionlabel "><strong>Which of the following products and services do you plan to recommend, specify, or approve the procurement of in the next 12 months? (choose all that apply)</strong> <font color="red">*</font> </span></p><ul><li class="licr538_78431 lier63333_78431 "><input name="demo63333" type="checkbox" value="78431" id="id538_78431"/><span class="checkboxlabel"><label for="id538_78431">AI/Machine Learning</label></span></li><li class="licr538_78430 lier63333_78430 "><input name="demo63333" type="checkbox" value="78430" id="id538_78430"/><span class="checkboxlabel"><label for="id538_78430">Citizen Experience/Digital Government</label></span></li><li class="licr538_1352 lier63333_1352 "><input name="demo63333" type="checkbox" value="1352" id="id538_1352"/><span class="checkboxlabel"><label for="id538_1352">Cloud Computing</label></span></li><li class="licr538_1354 lier63333_1354 "><input name="demo63333" type="checkbox" value="1354" id="id538_1354"/><span class="checkboxlabel"><label for="id538_1354">Cybersecurity</label></span></li><li class="licr538_1357 lier63333_1357 "><input name="demo63333" type="checkbox" value="1357" id="id538_1357"/><span class="checkboxlabel"><label for="id538_1357">Big Data Management and Analytics</label></span></li><li class="licr538_78429 lier63333_78429 "><input name="demo63333" type="checkbox" value="78429" id="id538_78429"/><span class="checkboxlabel"><label for="id538_78429">Emerging Technology</label></span></li><li class="licr538_1358 lier63333_1358 "><input name="demo63333" type="checkbox" value="1358" id="id538_1358"/><span class="checkboxlabel"><label for="id538_1358">Systems/Hardware/Software</label></span></li><li class="licr538_1360 lier63333_1360 "><input name="demo63333" type="checkbox" value="1360" id="id538_1360"/><span class="checkboxlabel"><label for="id538_1360">Health IT</label></span></li><li class="licr538_78984 lier63333_78984 "><input name="demo63333" type="checkbox" value="78984" id="id538_78984"/><span class="checkboxlabel"><label for="id538_78984">Infrastructure Solutions</label></span></li><li class="licr538_78435 lier63333_78435 "><input name="demo63333" type="checkbox" value="78435" id="id538_78435"/><span class="checkboxlabel"><label for="id538_78435">IT Modernization</label></span></li><li class="licr538_1353 lier63333_1353 "><input name="demo63333" type="checkbox" value="1353" id="id538_1353"/><span class="checkboxlabel"><label for="id538_1353">Mobility Solutions</label></span></li><li class="licr538_1356 lier63333_1356 "><input name="demo63333" type="checkbox" value="1356" id="id538_1356"/><span class="checkboxlabel"><label for="id538_1356">Network/Systems Mgmt</label></span></li><li class="licr538_78433 lier63333_78433 "><input name="demo63333" type="checkbox" value="78433" id="id538_78433"/><span class="checkboxlabel"><label for="id538_78433">Public Safety</label></span></li><li class="licr538_78432 lier63333_78432 "><input name="demo63333" type="checkbox" value="78432" id="id538_78432"/><span class="checkboxlabel"><label for="id538_78432">Smart City/IoT Solutions</label></span></li><li class="licr538_79052 lier63333_79052 "><input name="demo63333" type="checkbox" value="79052" id="id538_79052"/><span class="checkboxlabel"><label for="id538_79052">Systems/Hardware/Software</label></span></li><li class="licr538_78428 lier63333_78428 "><input name="demo63333" type="checkbox" value="78428" id="id538_78428"/><span class="checkboxlabel"><label for="id538_78428">Workforce & Training</label></span></li></ul></span><div class="subheader">Newsletter Subscriptions <small>(optional)</small> - Select the newsletters you wish to receive</div><span class="spanc514 drg-element-type-demographic drg-element-sub-type-type-1"><p id="p514" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><strong>Format:</strong> </span></p><ul><li class="licr514_1227 lier63042_1227 "><input name="demo63042" type="radio" value="1227" id="id514_1227"/><span class="radiolabel"><label for="id514_1227">HTML</label></span></li><li class="licr514_1228 lier63042_1228 "><input name="demo63042" type="radio" value="1228" id="id514_1228"/><span class="radiolabel"><label for="id514_1228">TEXT</label></span></li></ul></span><div id="showoptdesc" style="display:block"><div id="showoptlabel">Show Description</div><div id="hideoptlabel" style="display:none">Hide Description</div></div><div id="pp5099" class="drg-element-type-product drg-element-sub-type-type-2"><input name="opt63044" type="checkbox" value="1" id="optp5099" [-checkedopt63044-]/><span class="questionlabel "><label for="optp5099"><strong>FCW Insider</strong> </label> </span><div id="longp5099" class="longdescopt" style="display:none"> Designed for federal executives, program managers and senior IT professionals, FCW Insider provides up-to-date news and information on the people, power and policies impacting the business of federal technology.</div></div><br><div class="subheader">Is there anyone else at your location who should receive a copy of FCW Magazine? 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