Beverage Industry Free Subscription

	*Beverage Industry* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Beverage Industry*, 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 Beverage Industry?*

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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/Mail Stop/Suite:
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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.

2.	What is the primary end product and/or activity at this location? (select only one)

Soft Drinks Mfg Juice/Fruit Drinks Distributor

Beer Mfg Coffee/Tea Distributor

Bottled Water Mfg Dairy based drinks Distributor

Alternative Beverages Mfg (including fortified/nutraceuticals) Other Beverage Distributor

Wine/Liquor Mfg Warehouse

Juice/Fruit Drinks Mfg Wholesaler

Coffee/Tea Mfg Broker

Dairy based drinks Mfg Fast Food Corp Hdqtrs

Other Beverages Mfg Retailer (including supermarkets/conv.stores/mass merchandiser, drug stores)

Soft Drinks Distributor Vending Firm

Beer Distributor Franchise Company

Bottled Water Distributor Flavor Mfg

Wine/Liquor Distributor Other (please specify)

Alternative Beverages Distributor (including fortified/nutraceuticals)

3.	What is the estimated dollar volume at this location? (select only one)

Over $50 Million $5 to $9.9 Million

$25 to $49.9 Million Under $5 Million

$10 to $24.9 Million

4.	What is your company's fleet size at this location? (select only one)

Over 20 Trucks 5-9

10-19 4 or less vehicles

5.	What is your title? (select only one)

President/Owner/Chairman of the Board Vending Manager

Executive VP/VP/GM/Secretary-Treasurer/Manager Truck Fleet Mgr/Repairs/Warehouse Mgr/RTE Mgr

VP Production/Production Mgr/Plant Mgr/Supv/Supt/Production Line Foreman Purchasing Agent/Buyer

Chemist & Flavor Room Mgr/R&D Other Titled and Non-Titled Personnel (please specify)

VP Sales/Sales Mgr/Marketing/Sales Personnel

6.	Do you recommend, approve or purchase any of the products listed below? (select all that apply)

Processing Equipment Sanitation & Maintenance

Ingredients Vending/Dispensing

Packaging Equipment Material Handling & Equipment

Packaging Materials POP Displays/Materials

Warehousing Other

Trucks & Bodies None of the Above

QA/QC, Instrumentation & Control

7.	How many employees at this location? (select only one)

1-19 100-499

20-99 500 and more

8.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. How many letters are in your father's first name?

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