| |
| 1. | Do you wish to receive a FREE subscription to CircuiTree? |
Yes
No
| 1a. | Please check your preferred format: |
Print Version of CircuiTree (USA and Europe only)
Digital Version of CircuiTree (USA and International)
| 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: |
|
| |
(Note: Valid email address is required or you could be disqualified.) |
| 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, we require a unique identifier used only for subscription verification purposes. What is your date of birth? |
| 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. BNP Media will not share this information or use it for any other purpose. Would you like to receive subscription faxes sent by CircuiTree/BNP Media? |
Yes
No
| 5. | Would you like to receive the CircuiTree e-newsletter FREE of charge? |
Yes
No
| 6. | What is your primary job function? (select only one) |
| 7. | What is your primary business? (select only one) |
| 8. | Please check the following as it applies to your company: (select only one) |
| 9. | Please indicate if you influence the design, specification or purchase of the following: (select all that apply) |
| 10. | Please check the following items that your company manufactures: (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. |
| |
 | Qualify for Your Eight Free Trial Issues of Automotive News! For more than 80 years Automotive News has been the leading source of news for the North American automotive industry. Distributed every week to more than 79,000 subscribers, it covers the manufacturing side of the automotive industry, including engineering, design, production and suppliers, with equal emphasis on the retail side of the industry, including the marketing, sales, service and resale of vehicles. If you like Automotive News, pay the special discounted rate of $155 for 44 more issues, for a total of 52 issues. That is less than $3 per issue. Otherwise, write "cancel" on the bill, return it, and owe nothing. |
| | Which of the following enewsletters do you wish to subscribe to? (select all that apply) |
| | Industry: (select only one) |
| | Job Function: (select only one) |
|
|