Request For Quotation Form

Please help us provide you with quote information by filling in the following questionaire:

Your First Name:
Your Last Name:
Position:
Company:
Address Street:
Town:
State:
Zip Code:
Country:
Phone:
Fax:
Email:

Type of Business:

Lottery (Government) Lottery (Private) Non-Profit Agency Charity organisation Sales Promotion Agency Advertising Agency Marketing Service Agency Other

---

Services You Are Interested In:

Lottery Services Internet Services Consultancy Services IVR Services Promotional Programs Game development Skill games Multi-player games

If "Other" please expand:

Media to be used:

Internet Telemedia Multimedia Interactive Television

Describe the project:

The above information will not, under any circumstances, be given to any other organisation.

---

---

Thank you for allowing us to provide you with further information!

Associated Interplay Companies

For further information

This site was developed by Interplay Multimedia Pty Ltd © 1997 Phone 61 2 4871 2911