Title of Software Program

Contributor

Institution

Address

Telephone Number

Fax Number

E-mail Address

Type of Program

Application
Utility
Other (Please describe)

Category (e.g., cardiology, pathology, etc.)

Level of potential users:

Field of Interest(s):

Developed for (name of computers):

• in the language(s) or authoring program (Please describe)
  
• to run under (operating system)
  
• Available on
  
  Floppy Disk
  CD-ROM
  Internet - Web Site Address

Special Hardware Required

Memory Required

Documentation

None
Minimal
Self-documenting
Extensive

Source Code Available?

Yes
No

Stage of Development

Design Complete
Ready to Beta Test
In-house only
Collaboration welcomed

Is the program in use?

Yes

For How Long?
At how many sites?

No

Is the contributor available for user inquiries?

Yes
No

Distributed by

Cost of program

Demonstration disk available?

Yes - Cost
No

Description of what the software does (maximum 200 words)