Date: Fri, 19 Dec 1997 17:32:23 GMT Server: Apache/1.2.4 Last-Modified: Sun, 14 Sep 1997 18:05:54 GMT ETag: "28511-107c-341c2782" Content-Length: 4220 Accept-Ranges: bytes Connection: close Content-Type: text/html HTML FORM using text entry

Information Request

Name
Company Name
Street Address
City
State
Zip Code	-
Country
Phone Number
E-Mail Address

Which of the following would you like to be added to?
Mailing List

I wish to receive the following:
Annual Report	10-K
Quarterly Report	10-Q
News Releases	Proxy
Analyst Reports
The following describes my interest in Mitcham Industries:
Shareholder	Analyst, my specilty is
Portfolio Manager	Fund Manager
Investment Banker	News Media
Registered Rep/Broker	Individual
Commercial Banker	Library
Vendor	Other