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| 1. | Do you wish to receive a FREE subscription to Food Product Design? |
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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. |
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| Other Grain Mill Products |
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| 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. |
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| Related FREE Offers from TradePub.com: Check those you wish to receive. |
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What is the approximate number of employees in your company? |
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Which best describes your Job Function? |
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Employee Size: |
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Which best describes your Organization's revenue? |
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What is your purchase timeframe? |
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Where do you primarily sell? (Please select one and provide the verification information requested. All information will be verified and invalid, incomplete entries will be disqualified.) |
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Storefront |
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Please provide the physical address (street, city, state and zip code) of your storefront. (Your storefront address must be a business address that can be verified by online business listings. Invalid, incomplete entries and all residential addresses will be disqualified.) |
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Kiosk/SRMU |
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Please provide the name of the mall/shopping center where you sell and its location (City, State). (Invalid, incomplete entries will be disqualified.) |
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Online (Please provide the name of the online marketplace where you currently sell, online store name/seller id or your website address.) |
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Amazon |
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(Your valid store name is required. Invalid, incomplete entries will be disqualified.)
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Ebay |
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(Your valid store name or seller ID is required. Invalid, incomplete entries will be disqualified.) |
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Yahoo |
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(Your valid store name is required. Invalid, incomplete entries will be disqualified.) |
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Your Own Website |
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(Your company's valid, working website URL is required. Invalid, incomplete entries will be disqualified.) |
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Other Website |
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(Please provide the URL or name of the online marketplace and a valid store name or seller ID. Invalid, incomplete entries will be disqualified.) |
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Other |
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Please Specify for Other: |
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What is your annual sales volume? |
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What is your percentage of total sales online? |
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What percentage of your inventory do you purchase online? |
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What is your birth month? (This is required in lieu of a signature to be used only to verify your subscription request.) |
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By providing your email address you grant BNP Media permission to contact you via email regarding your subscription and other products/services.
By providing your fax number you grant BNP Media permission to contact you via fax regarding your subscription and other products/services.
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Please indicate the type of product your company manufactures/processes/distributes at this location: |
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Please indicate your job title: (select only one) |
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General Management/Administration (President, Owner, Partner, Vice President, General Manager, Assistant Manager) |
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Plant Operation/Production (Plant Manager, Production Manager, Traffic Manager, Packaging Manager, Maintenance Manager, Distribution Manager) |
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Research and Development (Technologist, Chemist, Scientist, Research Technologist, Group Project & Research Scientist, QC/QA Manager) |
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Engineering (Engineers: Chief, Project, Design, System) |
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Sales/Marketing (Director, Manager, Brand, Assistant, Advertising) |
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Purchasing (Purchasing Director, Supervisor, Agent, Buyer) |
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Other (Other Titled Personnel) |
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Please specify for Other: |
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Do you recommend, specify, approve, or purchase any of the following: (select all that apply) |
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Please indicate the number of employees at this location: |
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In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. What is your date of birth? |
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