| |
| 1. | Do you wish to receive a FREE subscription to Restaurant Business? |
Yes
No
| 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: |
|
| Fax: |
|
| 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)
| | 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 for a commercial foodservice location such as: restaurant, hotel, resort, club (excluding military)? |
Yes
No
| 4. | Which one of the following best describes your title? (select only one) |
| Company Officer: President, Owner, Partner, Vice President, Secretary, Treasurer, Operator |
| Food Service Management: Manager or Director of Food Service, Food/Beverage, Dining Service, Dietitian, Chef |
| Operations Management: Administrator, Innkeeper, General Manager, Business Manager |
| Purchasing Operations: Purchasing Director, Purchasing Agent, Buyer |
| Other (please specify) |
| 5. | What term best describes your restaurant/establishment? (select only one) |
| 6. | What is your company's gross annual food/beverage sales including alcoholic beverages? (select only one) |
| 7. | How many units/locations with foodservice does your organization operate? (select only one) |
| 8. | Please identify your areas of responsibilities within your operation? (select all that apply) |
| 9. | Identify the type of location in which you work? (select only one) |
| 10. | As an added value, you will automatically receive the FREE RB Email Newsletter. If you DO NOT WISH TO RECEIVE this, please indicate by checking the box below. |
I do not wish to receive the enewsletters.
| 11. | In lieu of a signature, we require a unique identifier used only for subscription verification purposes. What is the month of your birth? |
| | 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. |
| |
Which of the following is closest to your job function? |
|
| |
What is the number of employees in your entire organization? |
|
| |
Which of the following is closest to your job function? |
|
| |
What is the number of employees in your entire organization? |
|
| |
What is the number of employees in your entire organization? |
|
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.
| |
Please indicate the type of product your company manufactures/processes/distributes at this location: |
|
| |
Please indicate your job title: (select only one) |
|
| |
General Management/Administration (President, Owner, Partner, Vice President, General Manager, Assistant Manager) |
| |
Plant Operation/Production (Plant Manager, Production Manager, Traffic Manager, Packaging Manager, Maintenance Manager, Distribution Manager) |
| |
Research and Development (Technologist, Chemist, Scientist, Research Technologist, Group Project & Research Scientist, QC/QA Manager) |
| |
Engineering (Engineers: Chief, Project, Design, System) |
| |
Sales/Marketing (Director, Manager, Brand, Assistant, Advertising) |
| |
Purchasing (Purchasing Director, Supervisor, Agent, Buyer) |
| |
Other (Other Titled Personnel) |
| |
Please specify for Other: |
| |
Do you recommend, specify, approve, or purchase any of the following: (select all that apply) |
| |
Please indicate the number of employees at this location: |
|
| |
In lieu of a signature, BNP Media 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. |
|
|