Outlaw Audio Special HDMI Beta Tester Application Form

In order to be considered for beta testing, all fields must be completed,
even when the answer is "None".

First Name
Last Name
Address 1
Address 2
City
State
Zip Code
E-mail
Day Phone
Evening Phone
Where do you access the Internet?	Choose Location At home At work At school At home and work At home and school At a public "cafe" or library
How do you connect to the Internet?	Choose Type Dial-up Broadband cable Broadband DSL Broadband satellite T-1 or other
Please describe the nature of the issues you have encountered with HDMI.
Do you own any Outlaw products?	Choose Answer Yes, purchased directly via internet Yes, purchased directly via phone Yes, purchased them used No (SHAME ON YOU, we'll have to do something about that!)
Tell us about your system’s location and how long you have had it.
How long have you had your present home theater system?	Choose Time Less than 3 months Less than 6 months Less than 12 months Less than 2 years Less than 5 years Less than 10 years
Do you live in a?	Choose Dwelling House Apartment
Where is this system located?	Choose Room Den/Family Room Bedroom Home Office Dedicated Home Theater Room Basement/Playroom
Tell us about the specific components in your system.
A/V Receiver?	Choose Brand None, I use a processor. Other ADA Adcom Anthem Aragon ATI Atlantic Technology B&K Cary Classe Denon Emotiva Fosgate Audionics Integra Integra Research Krell Lexicon Linn McIntosh Marantz Mark Levinson Meridian NAD Outlaw Parsound Pioneer Elite Proceed Rotel Sherbourn Sherwood Sony Sony ES Yamaha
Surround Processor/Preamp?	Choose Brand None, I use a receiver. Other ADA Adcom Anthem Aragon ATI Atlantic Technology B&K Cary Classe Emotiva Fosgate Audionics Integra Integra Research Krell Lexicon Linn Marantz McIntosh Mark Levinson Meridian NAD Outlaw Parsound Pioneer Elite Proceed Rotel Sherbourn Sherwood Sony Sony ES Yamaha
Tell us about your video display.
Display Type?	Choose Type Analog Direct View CRT HD Direct View CRT ED Plasma HD Plasma ED Direct View LCD Panel HD Direct View LCD Panel Analog CRT Front Projector HD CRT Front Projector Analog CRT Rear Projector HD CRT Rear Projector DLP Front Projector DLP Rear Projector LCD Front Projector LCD Rear Projector LCoS Front Projector LCoS Rear Projector
What is the make and model of your video display?
Tell us about your audio/video sources.
How do you receive“broadcast” television channels? (please select all that apply)	Off-air via built-in tuner
	Off-air using external HD set-top
	Analog Cable
	Digital Cable
	HD Cable
	DirecTV
	EchoStar
What source do you use for “pay” and “premium” networks? (please select all that apply)	Off-air via built-in tuner
	Off-air using external HD set-top
	Analog Cable
	Digital Cable
	HD Cable
	DirecTV
	EchoStar
What is the make and model of your cable or satellite box?
Do you have any HD sources? (please select all that apply)	No
	Off-air via built-in tuner
	Off-air using external HD set-top
	Analog Cable
	Digital Cable
	HD Cable
	DirecTV
	EchoStar
	4-D (C-Band)
Does your system include an outboard video scaler or processor?	Please Select Yes No
How does your HD program source connect to your display? (please select all that apply)	Composite Video
	S-Video
	Y/Pr/Pb Component Video
	RGB Component Video
	DVI
	HDMI
	Built-in to display
What is the make and model of your DVD/Blu-ray player?
How do you connect your DVD/Blu-ray player to your receiver or processor for audio? (please select all that apply)	Optical
	Coax
	HDMI
	iLink/IEEE1394
	Analog 6CH
How do you connect your DVD/Blu-ray player to your receiver, processor or display for video? (please select all that apply)	Composite
	S-video
	Component
	HDMI
	iLink/IEEE1394
Do you have a video game console connected to your home theater system?(please select all that apply)	No
	PlayStation 3
	X-box 360
	Other
If yes to the above question, do you connect your video game system using an HDMI cable?	Please Select Not Applicable No Yes
Do you have a “DVR” connected to your system using HDMI cables?	Please Select No Analog TiVo, Replay or similar Yes, SD TiVo/DirecTV or Dishplayer Yes, HD TiVo/DirecTV or Displayer Yes, DVR cable set top Yes, DVR cable set top with HD
Do you have a “Media Server” or hard-drive product connected to your system using HDMI cables?	Please Select Yes No
Is your system connected to a computer for audio/video playback over an HDMI connection?	Please Select No Yes, directly Yes, via a “Media Center Extender” or similar product
Tell us about your HDMI connections.
Please describe the make, model, and length of each of your HDMI cables.
Clicking "Submit" will complete the application form.

Any trademarks that are resident in the product or brand names used in this
application are acknowledged as the property of the respective copyright or
trademark owner. This application and the associated copy is Copyright (c) 2011
by Outlaw Audio, LLC. All Rights Reserved. Any duplication, posting, web-link,
reproduction or other use is strictly prohibited.