FoodService Director Free Subscription

	*FoodService Director* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *FoodService Director*, 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

1.	*Do you wish to receive a FREE subscription to FoodService Director?*

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First Name:
Last Name:
Job Title:
	(Ex: Director, Vice President, Project Manager, etc.)
Company Name:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Business Address:
Dept/Mail Stop/Suite:
City:
State/Province:
Zip Code/Postal Code:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Phone:
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Email Address:
	(Note: Valid email address is required or you could be disqualified.)

As an important subscriber, Ideal Media values the privilege of contacting you via email. Ideal Media will not sell your email address, and you will be given the opportunity to opt-out of any email correspondence you receive.

2.	Indicate your preferred delivery address:

Business Address (above) Home Address (below) P.O. Box (below)

Delivery Address (if different from business address above)

Home Address or P.O. Box:

City:

State, Province or Territory:

Zip Code/Postal Code:

Country:

What is the approximate number of employees in your company? (select only one)

Yes, please auto-fill my contact information for other publication qualification forms.

3.	Are you a decision maker who works for a non-commercial foodservice operation in the United States?

Yes No

4.	At which of the following locations do you work? (select only one)

A self-operated food service location (go to question 5)

A contact managed foodservice location (go to question 5)

A foodservice location that is partly self-operated and partly contract managed (go to the next question)

A national or main headquarters of a contract management company (go to the gross annual food/beverage purchases)

None of the Above (go to the next question)

5.	Which of the following market segments best describes your foodservice operation? (select only one)

Employee Feeding in an office, plant or factory Correctional Facilities

Hospital Military / Military Club

Nursing Home Group Purchasing Association or Organization

Long Term Care / Retirement Home Recreational Facility / Concession

College and University Other (please specify)

School District (Elementary / Secondary)

Individual Primary or Secondary School

6.	What are your gross annual food/beverage purchases for non-commercial establishments including alcoholic beverages? (select only one)

$5 Million and over $200,000 to $299,999

$1 Million to $4,999,999 $100,000 to $199,999

$500,000 to $999,999 Under $100,000

$300,000 to $499,999

7.	Which of the following best describes your title? (select only one)

Food Service Management (Manager or Director of Food Service, Food/Beverage, Dining Service, Dietician, Chef)

Operations Management (Administrator, General Manager, Business Manager)

Purchasing Operations (Purchasing Director, Purchasing Agent, Procurement Officer, Buyer)

Company Officer (President, Partner, Owner, Executive VP, VP, Senior VP, Secretary, Treasurer, Controller)

Corporate Liaison

Other (please specify)

8.	How many foodservice establishments are you responsible for? (note: whole number please; ranges cannot be accepted)

9.	Which of the following services do you offer? (select all that apply)

Vending Coffee / Snack Bars

Catering None of the Above

Convenience Stores

10.

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11.

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* The publisher reserves the right to limit the number of free subscriptions and/or reject requests based on information provided.