Contact

Company and store information

1. Company Name
2. State/Providence Please Select N. A. Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Pennslyvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Yukon Territory
3. Country United States Canada Australia Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Australia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea (People's Rep. of Korea) South Korea (Republic of Korea) Kuwait Kyrgyzstan Lao People's Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and South Sandwich Isl. Spain Sri Lanka Saint Helena Saint Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Switzerland Sweden Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay U.S. Minor Outlying Islands Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis And Futuna Islands Western Sahara Yemen Zaire Zambia Zimbabwe Other (not listed)
4. Number of Stores

5. Contact person for digital content operations

   1. Name
   2. Title
   3. Phone
   4. Fax
   5. E-mail

Rollout details

1. Number of trial stores 1 2 3 4 5 6-10 more than 10
2. Number of stations per store 1 2 3 4 5 6-10 more than 10
3. Target launch date Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2007 2008
4. Estimated budget per store for equipment? less than $5,000 $5,000 - $10,000 $10,000 - $20,000 $20,000 - $40,000 over $40,000

5. Requested capabilities

   1. Merchandising
   2. Device synchronization
   3. Burn to CD
   4. Burn to DVD

6. Additional system features

   Do you have other in-store applications you would like to use on this system?

   1. Digital signage
   2. In-store audio
   3. Video training for employees
   4. Merchandising of ringtones
   5. Bill payment
   6. Other (please describe)

7. Point-of-Sale integration

   Do you want to integrate your existing payment system into your kiosk devices, or do you want to use MOD's integrated payment system (MOD System recommended)

   1. MOD System
   2. Use existing system

8. Internet connection

   What type of internet connection will be available?

   1. Landline (Dial-up)
   2. DSL/Cable
   3. Satellite
   4. T1
   5. Other
   6. None

9. Affinity cards

   Do you have an affinity card?

   1. Yes
   2. No

   If yes, does it have a magnetic strip or a barcode?

   1. Magnetic strip
   2. Barcode
   3. Both
   4. None

Value survey

Please answer the following questions by selecting the number that best describes your opinion (1 - Strongly disagree; 10 - Strongly agree)

1. We want to offer our customers the ability to create music compilations
   1. 1
   2. 2
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   10. 10
2. We want to offer customers a broader selection of movies and music
   1. 1
   2. 2
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   8. 8
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   10. 10
3. We want to burn our own movies rather than order them from a distributor
   1. 1
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   9. 9
   10. 10
4. We want to make more efficient use of our space by offering media through digital download or burn-on-demand
   1. 1
   2. 2
   3. 3
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   5. 5
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   7. 7
   8. 8
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   10. 10
5. We feel digital distribution will cost less and create a more favorable ROI than our current model
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   2. 2
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   4. 4
   5. 5
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   7. 7
   8. 8
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   10. 10
6. We feel MOD offers a more efficient method of inventory management than our current system
   1. 1
   2. 2
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   10. 10
7. We want to upgrade our existing website with components that MOD Systems offers
   1. 1
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   8. 8
   9. 9
   10. 10

Support staff

1. How many people, on average, work at each location as dedicated IT support? 0 1 2 3 or more
2. Approximately how many IT support personnel work at your corporate office? 0 1 2 3 4 5 or more

3. Do you currently employ a digital content manager?

   1. Yes
   2. No

Store inventory

1. How many square feet is your average store?
2. What is the average dollars/sq. ft. per store?
3. On average, how many DVD titles does each store keep in inventory?
4. If you stock DVDs, how many copies of a new release DVD do you order prior to street date?
5. If you stock DVDs, how many copies of titles older than 90 days do you keep in inventory?
6. On average, how many unique CD albums does each store keep in inventory?
7. If you stock CDs, how many copies of a new release CD do you order prior to street date?
8. If you stock CDs, how many copies of CDs older than 90 days do you keep in inventory?
9. How many DVD titles would you like to offer for digital download?
10. How many new DVD titles do you bring into your average location on the average week?