Applied Clinical Trials
  Applied Clinical Trials is free to qualified professionals. Summary Description
  To apply for a FREE subscription to Applied Clinical Trials, please answer ALL of the questions on the form below.
  The magazine publisher determines qualification and reserves the right to limit the number of free subscriptions.
  Geographic Eligibility: USA, Canada, Selected Western Europe


 
1. Do you wish to receive a FREE subscription to Applied Clinical Trials?
Yes     No


First Name:
Last Name:
Job Title:
(Ex: Director, Vice President, Project Manager, etc.)
Company:
(Please provide your Company Name in full: abbreviations could disqualify you)
Address:
Address2:
City:
State/Province:
Zip Code:
Country:
(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Phone:
Fax:
Email Address:
(Note: Valid email address is required or you could be disqualified.)
Is this your home address? Yes     No

Advanstar Communications provides certain customer contact data (such as customers' names, addresses, phone numbers and email addresses) to third parties who wish to promote relevant products, services and other opportunities which may be of interest to you. If you do not want Advanstar Communications to make your contact information available to third parties for marketing purposes, check below.
No, do not provide my contact data to third parties.
 
Yes, please auto-fill my contact information for other publication qualification forms.
  What is the approximate number of employees in your company? (select only one)


2. My primary business is: (select only one)
Pharmaceutical/Biopharmaceutical/Biologics Company Data Management
Contract Research Organization (CRO) Government
Trial/Site Management Organization (TMO/SMO) Drug Development/Clinical Trials Consulting Company
Clinical Study/Investigative Site (includes Academic/Medical Research Facility) Independent CRA
Clinical Laboratory Other (please specify)


3. My primary job function is: (select only one)
Research & Development/Project Management (includes Trials Design/Protocol Development)
Clinical Trials Management
Clinical Trials Associate (CRA/Monitor)
Clinical Research Coordinator (CRC, Study Coordinator, Research Nurse)
Clinical Trials/GCP Auditing/QA/QC
Laboratory Analysis
Data Management/Analysis/Biostatistics
Regulatory Affairs/Compliance (includes Drug Safety & Pharmacoviligilance)
Marketing
Corporate Management (includes Medical Director/Medical Affairs)
Academic/Research/Teaching
IT Management
Clinical Supply/Materials
Contract Management/Outsourcing
Other (please specify)


4. My job title is: (select only one)
CEO/President/Managing Director Manager
Project Manager/Leader Associate Director
Vice President/Director Medical Director/Director Medical Affairs
Professor/Academic Position Clinical Data Specialist
Supervisor of Clinical Systems Clinical Research Coordinator (CRC)
QC/QA Officer Other (please specify)
Clinical Research Associate/Monitor (CRA)


5. To permit future verification of your request, please answer ONE of the following questions: What day of the month were you born? (1st, 2nd, etc.) OR What city were you born in?


  Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com?
Yes     No
  Sign up for special offer alerts from select partners featuring the latest products and services you are interested in.
Yes     No

 
Related FREE Offers from TradePub.com: Check those you wish to receive.

Request Your Free White Paper: HIPAA and Beyond - How to Effectively Safeguard Electronic Protected Health Information. Explore how to go beyond HIPAA by learning how to use HIPAA as the starting point for your security program. By using best practices and Lumension Security solutions, you can work to improve your overall security posture. Note: Offer Valid in the United States Only.
  Which of the following best describes your industry? (select only one)
Agriculture Healthcare Service Provider
Apparel Healthcare
Banking Hospital
Biotech Insurance
Chemical Manufacturing
Communication Media
Construction Not for Profit
Consulting Pharmaceutical
Education Retail
Electronics Shipping
Energy Technology
Engineering Telecommunications
Entertainment Transportation
Environmental Utilities
Finance Other (please specify)
Food and Beverage
. Please select the category that best describes your title: (select only one)
General and Financial Management Information Management cont.
CEO, President, Executive Director, Administrator Other IT Personnel (please specify)
CFO, Finance Director/Manager
CSO/Security Officer/Director Network/MIS/Data Processing Director/Manager
Planning Officer/Director Health Information Director/Manager
Marketing Officer/Director Coding/DRG Director/Manager
COO, VP, Assistant Administrator Systems Administrator/Analyst/Network Specialist/Project Manager
CCO, Compliance Director/Manager Clinical Management
CPO/Purchasing/Materials Management Director/Manager Chief of Staff/Medical Director/VP of Medical Affairs
Quality Officer/Director Chief of Pathology/Pathologist
Other Administrative Title (please specify) Chief of Radiology/Radiologist
Other Clinical Administration (please specify)
Information Management
CIO, VP of Information Systems, Tech Officer Chief of Laboratory Services/Lab Administrator
Chief of Medical Records/Medical Records Manager Chief of Pharmacy/Pharmacist
Director/Manager of Medical Informatics Chief/VP of Nursing Services/Asst Director/Case Manager
Director/Manager of Telecommunications/Call Center Director/Manager Other Title (please specify)
  What is the number of employees in your entire organization? (select only one)
less than 50 1,000-4,999
50-99 5,000-9,999
100-499 10,000-19,999
500-999 20,000+
A FREE 6-month subscription to AOPA Flight Training magazine! AOPA Flight Training magazine offers the insight and counsel of experienced pilot-authors to help both instructors and pilots-in-training as they progress toward their goals in aviation. Get advice on how to become a pilot, select a flight school and instructor, as well as guidance, training techniques, and tips from experienced pilots. Limit of one free offer per person and cannot be combined with a paid AOPA membership. If you hold a private rating or above, you do not qualify for the free offer. Note: Offer Valid in the United States Only.
  What stage of flight training have you reached? (select only one)
Still considering Completed my solo cross-country
Looking for a CFI/flight school Earned my private pilot certificate
Had my first flight Other (please specify)
Completed my first solo
  What is your highest aspiration? (select only one)
Recreational Professional Pilot
Business No aspiration at present time
CFI
  Your Age: (select only one)
<16 54-67
17-24 68-81
25-39 81+
40-53
Pharm Rep Direct is the free biweekly newsletter from the editors of Pharmaceutical Representative. It covers new developments and cutting-edge advice from the world of sales management and training, as well as regulatory updates, must-know court cases, key statistics, exclusive interviews - you can find everything you need here, in Pharm Rep Direct. Note: Offer Valid in the United States, Canada, Mexico, and International Only.
  Which of the following best describes your industry? (select only one)


Please specify for Other:
  Which of the following is closest to your job function? (select only one)


Please specify for Other:
  What is the approximate number of employees in your company? (select only one)
Try 4 Issues of BusinessWeek - Risk Free! Success-minded professionals trust BusinessWeek for a deeper understanding of the trends that drive growth, how technology creates opportunities, and what best practices keep them ahead of the competition. Leaders of today and tomorrow turn to BusinessWeek for information, insight, and inspiration they can't get anywhere else.

Gain the advantage. Subscribe to BusinessWeek for a fraction of the cover price! You will receive 4 RISK-FREE issues of BusinessWeek plus access to the latest issue online. You can choose to:
  • Continue to receive 8 additional issues (12 issues total) for just $11.88. That's only 99¢ per issue! 80% savings off the newsstand cover price!
  • Continue to receive 21 additional issues (25 issues total) for just $20.00. That's only 80¢ per issue! 84% savings off the newsstand cover price!
  • Keep just the 4 FREE trial issues and owe nothing by returning the bill marked "cancel".
*BusinessWeek's newsstand price is $4.99 per issue.

Note: Offer Valid in the United States Only.
  Please choose from one of the following offers: (select only one)
Continue to receive 8 additional issues (12 issues total) for just $11.88. That's only 99¢ per issue! 80% savings off the newsstand cover price! Keep just the 4 FREE trial issues and owe nothing by returning the bill marked "cancel".
Continue to receive 21 additional issues (25 issues total) for just $20.00. That's only 80¢ per issue! 84% savings off the newsstand cover price! Keep just the 4 FREE trial issues and owe nothing by returning the bill marked "cancel".
Please indicate your privacy preferences below:
Please do not share my contact information with 3rd parties.
Please do not share my contact information with other parts of The McGraw-Hill Companies.
Please do not send me any further BusinessWeek mailings.

  Please indicate your industry: (select only one)
  Please select your job title: (select only one)
  Does your company have 1-300 employees?
Yes     No
  Is the mailing address on your subscription currently your home or business address?
HOME ADDRESS     BUSINESS ADDRESS

     

* Note that a valid email address is required to fulfill your request. Please verify that the email and mailing address you provided are accurate before hitting the submit button.
* The publisher reserves the right to limit the number of free subscriptions and/or reject requests based on information provided.


Problems with the form? Webmaster@TradePub.com
Copyright © 2008 NetLine Corporation, All Rights Reserved.
Copyright © 2008 Applied Clinical Trials, All Rights Reserved.