| |
| 1. | Do you wish to receive a FREE subscription to appliance 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) |
| Street Address: |
|
| Department/Mail Stop: |
|
| City: |
|
| State/Province: |
|
| Zip/Postal Code: |
|
| Country: |
|
| |
(Note: If your country is not listed above, subscriptions are not currently available at your location.) |
| Email Address: |
|
| Business Phone: |
|
| Business Fax: |
|
| |
You will receive subscription and renewal notices from BNP Media via email. |
 |
| 2. | Optional: If you want delivery to your home or Business P.O. Box, please complete the area below. |
| Home Street Address or P.O. Box: |
|
| City: |
|
| State/Province: |
|
| Zip/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. | In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. How many letters in your father's first name? |
| 4. | Your fax number is used to communicate to you. By providing your fax number, you are giving your written permission to receive subscription and other related information from BNP Media that may be of interest to you by fax. We will not share this information or use it for any other purpose. Would you like to receive subscription faxes sent by appliance DESIGN/BNP Media? |
Yes
No
| 5. | Would you like to receive the appliance DESIGN e-newsletter FREE of charge? |
Yes
No
| 6. | Please check your preferred format: (select only one) |
Print Version of appliance DESIGN (FREE for USA residents only)
Digital Version of appliance DESIGN (FREE)
| 7. | Would you like to receive International Appliance Manufacturing for FREE? |
Yes
No
| | Please check your preferred format of International Appliance Manufacturing? |
Digital
Print
| 8. | Check the category that best describes your primary job function. (select only one) |
| 9. | Please check the one category that best describes the primary business activity at your location. (select only one) |
| 10. | In the performance of my job, I recommend, specify, approve or purchase the following types of products listed below. (select all that apply) |
| Switches, Relays, Thermal Cutoffs, Circuit Breakers, Fuses |
Microcontrollers, Integrated Circuits & Other Electronic Components |
| Displays, Indicators, Lamps, LEDs |
Test & Measurement Equipment, Testing & Certification Labs/Services |
| Metals (Steel, Aluminum, Copper, Precoated/Prefinished Metals) |
Plastics, Elastomers |
| Metal Parts (Stamping, Casting, Powder Metal Parts, Springs, Hinges) |
Plastic Molding/Forming Services |
| Assembly Equipment & Tools, Welders, Clinching Machines, Brazing Machines, Fasteners, Dispensing Equipment, Adhesives & Tapes |
Heating Elements/Igniters |
| Motors, Fans, Blowers, Pumps, Motor Controllers |
Solenoids, Valves, Actuators |
| Controls, Sensors, Thermostats |
Connectors, Cords, Wire, Cable, Terminating Machines |
| Decorative Products (Trim, Nameplates, Glass Labels, Graphic Overlays) |
Other (specify) |
| Coatings, Paints, Finishing & Finishing Equipment |
|
| Seals, Gaskets, & Gasketing Equipment |
None of the above |
| Software |
|
 |
| 11. | Check the publication(s) listed below that you receive personally. (select all that apply) |
| | 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. |
| |
 |
I wish to receive a FREE subscription to Product News Alert.
Only the news you need, when you need it. Customized news alerts featuring new developments and information on the products and services that matter to you most. You choose from over 50 product categories including Adhesives and Sealants, Controls and Controllers, HVAC, Lubricants, Software, Welding Equipment, and more. Receive personalized news releases on only the information you want to know about. These updates are available daily, semiweekly or weekly.
Note: Offer Valid in USA, Canada, Mexico Only.
|
| |
Industry: |
|
| |
Job Function: |
|
| |
How did you hear about Product News Alert? |
|
| |
Yes, email me ThomasNet.com Product News Alert, current news releases about the products and services I choose. Select Your Product News Categories: |
| |
Frequency: |
|
| | How would you like to receive your copy of Underground Construction? |
Print
Digital
| | Please select the category which best describes your company's activity. |
Please specify for Other.
| | Please select your job title/job function. |
Please specify for Other.
| | My company is involved in trenchless construction methods. |
Yes
No
| | What is your company's annual construction volume? |
| | What is the estimated replacement value of equipment owned? |
| | May Underground Construction use email to contact you about other product offerings? |
Yes
No
| | What city were you born in? (This question acts only as a verification to confirm that you personally requested the subscription.) |
| |
Number of employees: |
|
| |
Type(s) of installations: (select all that apply) |
|
| |
Systems/Products currently installed: (select all that apply) |
|
| |
In which ways may United Publications contact you regarding your subscription? (please indicate all acceptable ways.) |
|
| |
In lieu of a signature, Audit Bureau regulations require that United Publications ask a validation question as proof of your request to subscribe. Please enter your response to the Personal Identifying Question below. From 1 through 31, what date in the month were you born? |
|
 |
| | Security Check: Enter both words below, separated by a space. |
|
|