Chain Drug Review Free Subscription

	*Chain Drug Review* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Chain Drug Review*, 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, Canada

1.	*Do you wish to receive a FREE subscription to Chain Drug Review?*

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By providing your email address, you are granting Chain Drug Review permission to contact you regarding your subscription. Please note, your email address will not be shared with any third party. If you do not wish to receive other email promotions from Chain Drug Review/Racher Press Inc., check here.

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.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. What state were you born in?

3.	My title is: (select only one)

Pres/CEO/Owner/Chairman Pharmacy Mgr.

VP/Director/GM/Other (please specify) Pharmacist

Pharmacy Technician

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District/Regional Mgr.

4.	My primary business activity is: (select only one)

Drug (Chain) On-line retailer

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Supermarket/Discount Other (please specify)

Wholesaler

5.	My Business Location is best described as: (select only one)

Headquarters Location of a chain Independent/Single Unit Establishment

District/Regional Location of a chain Other (please specify)

Store Location of a chain

6.	Number of Stores my business operates: (select only one)

1 Store 11-49 stores

2-3 stores 50-99 stores

4-10 stores 100 + stores

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

H&BA/Cosmetics Magazines/Books

Rx Drugs/Generics Snacks/Beverages

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Jewelry Audio Video

Tobacco Private Label

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None of the above

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