| |
| 1. | Do you wish to receive a FREE subscription to Food Product Design? |
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: |
|
| Dept/Div: |
|
| City: |
|
| State: |
|
| Zip: |
|
| 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.) |
Yes, please auto-fill my contact information for other publication qualification forms.
| 2. | What is your company's primary business? (select only one) |
| Prepared Foods |
Bakery Products |
| Food Service, Fast Food, QSR |
Bread, Cakes & Related Products |
| Prepared Dinners, Meals, Side Dishes |
Cookies and Crackers |
| Frozen Specialties, Dinners |
Other Bakery Products |
| Meat |
Confectionery |
| Sausages/ Other Prepared Meats |
Candy & Confectionary |
| Poultry Processing |
Chocolate & Cocoa Products |
| Other Meat Products |
Chewing Gum |
| Dairy |
Other Confectionary Products |
| Creamery Butter |
Beverages |
| Cheese, Natural & Processed |
Malt Beverages |
| Condensed & Evaporated Milk |
Wines, Brandy & Brandy Spirits |
| Ice Cream & Frozen Desserts |
Distilled & Blended Liquor |
| Fluid Milk |
Bottled & Canned Soft Drinks |
| Other Dairy Products |
Flavoring Extracts & Syrups n.e.c. |
| Preserved Fruits & Vegetables |
Other Beverage Products |
| Canned Specialties |
Other Food Products |
| Canned Fruits & Vegetables |
Seafood Canned & Cured |
| Dehydrated Fruits, Veg, Soups |
Seafood Prepared Fresh/ Frozen |
| Pickles, Sauces, Salad Dressings |
Coffee Roasted/ Flavored |
| Frozen Fruits & Vegetables |
Potato Chips, Corn Chips & Snacks |
| Other Fruits & Vegetables |
Macaroni, Spaghetti, Noodles |
| Grain Mill |
Nuts & Seeds Salted/ Roasted |
| Flour, Dough, Prepared, Blended |
Shortening & Cooking Oil |
| Cereal Breakfast Foods |
Processed Food Ingredients |
| Dog, Cat & Other Pet Foods |
Other Food Prod & Food Preparations (please specify) |
| Prepared Feeds n.e.c. |
|
| Other Grain Mill Products |
|
 |
| 3. | What is your job title? (select only one) |
| 4. | How many employees work at this location? (select only one) |
| 5. | For which of the following applications are your products/services used? (select only one) |
| 6. | Do you plan to introduce a new product or expand an existing product line in the next 24 months? |
Yes
No
| 7. | Which of the following products do you buy, specify, recommend or influence the purchase of for your company? (select all that apply) |
| 8. | In the performance of your job, in which of the following functions are you involved? (select all that apply) |
| 9. | In order to permit future verifications of your request for a free subscription, we need to ask you a personal identifier. What state were you born in? |
| 10. | Please select whether or not you would like to receive the Food Product Design e-newsletter. |
Yes
No
| | 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. |
| |
What is the approximate number of employees in your company? |
|
| |
Which of the following is closest to your job function? |
|
| |
Which of the following best describes your industry? |
|
| |
|
| |
Please Specify for Other: |
| |
What is the approximate number of employees in your company? |
|
| |
What is the size of your health delivery organization? |
|
| |
Is your organization a: |
|
| |
Which of the following areas do you think would benefit your organization the most? |
|
| |
|
| |
What is your primary job function? (select only one) |
|
| |
General or Corporate Management (incl. Executive, Financial, Administrative) |
| |
Engineering Management/Supervision |
| |
Engineering (incl. Planning, Design, Performance, R&D) |
| |
IT Management/Operations (Power System Automation, Controls, Communication, Hardware/Software, Metering, GIS, CIS, Billing) |
| |
Operations Management/Supervision |
| |
Operations (incl. Construction, Maintenance, Fleet) |
| |
Marketing, Customer Service, DSM |
| |
Other |
| |
Please specify for Other: |
| |
Source(s) of energy: (select all that apply) |
|
| |
Which of these products/services do you help acquire, recommend, specify or select? (select all that apply) |
| |
In lieu of a signature, PennWell requires a personal identifier. What is the first letter of your mother's maiden name? |
|
|
 |
I wish to receive a FREE subscription to Beverage Industry.
Beverage Industry is edited for decision makers in the multiple beverage markets: soft drinks, beer, bottled water, juice, wine and spirits. Each month, it provides an analytical look at marketing distribution, technology, production and other current news issues facing the industry. In depth statistical reports are compiled annually on each beverage market. Other key areas of coverage include packaging/recycling, beverage fleets, merchandising, quality control, computers, fountain/food service, vending and ingredients.
Note: Offer Valid in the USA (Print Version Only), Canada, Mexico & International (Digital Version Only).
|
| |
By providing your email address you grant permission to BNP Media to contact you via email regarding your subscription and other products/services. |
| |
By providing your fax number you grant permission to BNP Media to contact you via fax regarding your subscription and other products/services. |
| |
Please check your preferred format: (select only one) |
|
| |
What is the primary end product and/or activity at this location? |
|
| |
What is the estimated dollar volume at this location? |
|
| |
What is your company's fleet size at this location? |
|
| |
Do you recommend, approve or purchase any of the products listed below? (select all that apply) |
| |
How many employees at this location? |
|
| |
In lieu of a signature, Beverage Industry requires a unique identifier used only for subscription verification purposes. What is your date of birth? |
|
 |
| | Security Check: Enter both words below, separated by a space. |
|
|