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Which of the following best describes your industry?

Select industry Agriculture Biotechnology and Chemical Business Process Management Computers, IT, Technology Content Management/Archiving Engineering Environmental Financial Services Food and Beverage Government and Public Service Healthcare Human Resources Industrial and Manufacturing Internet Information Management Media and Marketing Networking and Communications Other Industries Telecommunications and Wireless Trade and Professional Services Transportation and Logistics Utility and Energy Please Specify for Other:

Which of the following is closest to your job function?

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Select number of employees Less than 50 50 - 99 100 - 499 500 - 999 1,000 - 4,999 5,000 - 9,999 10,000 - 19,999 20,000 +

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Select Industry Aerospace Agriculture Analyst/Research/PR Architecture/Engineering/Construction Automotive Consulting Consumer Products Education - Higher Ed Education - K-12 Entertainment Financial Services Financial Services - Insurance Food/Beverage Government - Local Government - State Government - Other Healthcare Hospitality Manufacturing: High Tech/Software Manufacturing: Other Military New Media/Publishing Not For Profit Oil/Gas/Chemical Other Pharmaceutical Research & Education Retail Transportation Utilities/Energy Wholesale Please Specify for Other:

Which best describes your Job Function?

Select Job Function Administration/Operations Asst VP/Vice President Business Development CFO/Controller/VP of Finance CIO / CTO / CSO Chairman/CEO/COO/President Consultant / System Integrator Contracts Administration Engineering Architect/Tech Staff Engineering Executive Engineering Management & Staff Finance Staff General Mgr / Divisional Mgr Human Resources IT - Application Management IT - Application Staff IT - Application VP/Director IT - Networking Management IT - Networking Staff IT - Networking VP/Director IT - Security Management IT - Security Staff IT - Security VP/Director IT - Web IT - Other Legal Legislative/Govt Affairs Marketing Exec / VP Marketing Marketing Management & Staff Operations / Manufacturing Pre / Post Sales Support Press and Analysts Product Management Purchasing Sales - Field Sales - Inside Sales Engineer Sales Executive / VP of Sales Sales Management Scientific/R&D Services & Support Strategy/Planning Student / Educator Other

Employee Size:

Select Employee Size Less than 100 100 - 499 500 - 999 1,000 - 4,999 5,000 - 9,999 10,000 or Greater

Which best describes your Organization's revenue?

Select Revenue Less than $10 Million $10 Million to $24 Million $25 Million to $99 Million $100 Million to $249 Million $250 Million to $499 Million $500 Million to $999 Million $1 Billion to $2.99 Billion $3 Billion to $6.99 Billion $7 Billion to $10.99 Billion $11 Billion to $19.99 Billion $20 Billion or Greater

Is this an impending project?

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What is your purchase timeframe?

Select Timeframe 0 - 3 months 4 - 6 months 7 months - 1 year More than 1 year Never

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I wish to receive a FREE subscription to Prepared Foods. It serves firms that develop, manufacture, process, package, and market food and beverage products. Prepared Foods provides the latest information on the newest developments in food science and research and development. Prepared Foods follows trends on food ingredients and food development and technologies for R&D and marketers in the food industry. Note: Offer Valid in USA, Canada Only.

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Check the category that best describes the primary product produced at your company: (select only one)

	Prepared Foods & Specialties/Ingredients: Including prepared dinners/meals/entrees (incl. ethnic foods); prepared side dishes; baby foods; pizza; ready-to-eat breakfast foods; pet foods; ready-to-mix desserts (incl. gelatin); peanut butter and pasta.
	Prepared Fruits & Vegetables/Ingredients: Including prepared fruits & vegetables, jams, jellies, preserves, soup & soup mixes; ketchup, sauces, gravies, condiments, seasonings, flavors & syrups; oils, salad dressing & mayonnaise, and pickled products.
	Prepared Meat, Poultry & Seafood/Ingredients: Including prepared meat, sausage, poultry, eggs, and seafood products.
	Dairy Foods/Frozen Novelties/Ingredients: Including cheese (imitation and natural); whipped toppings; margarine & butter, ice cream & frozen novelties; yogurt, cottage cheese, dips, sour cream, milk & milk substitutes.
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	Beverages/Ingredients: Including coffee & tea; non-carbonated beverages & beverage mixes; fruit & vegetable juices, carbonated beverages; wine, beer, liquor.
	Snack Foods/Candy/Ingredients: Including potato chips, corn & other chips, pretzels, nuts, popcorn, granola bars, meat snacks, candy, gum, chocolate.
	Manufacturer of Nutritional Supplements, Nutraceuticals and/or Ingredients
	R&D Center or Headquarters of a Food and/or Beverage Manufacturer
	Food Service
	Universities
	Independent R&D Labs, Government
	Other
	Please specify for Other:

In the performance of your job, in which of the following functions are you involved: (select all that apply)

	Research and Development	Purchasing
	New Product Development	Marketing/Brand/Product Management
	Food Service Product Development	None of the Above
	Laboratory Management/QA/QC

What is the total number of employees at this location?

Select number of employees 500 or more 250-499 100-249 50-99 1-49

Check the products you buy, specify, recommend, or influence the purchase of for your company: (select all that apply)

	Ingredients	Product Development/Recipe/Nutritional Analysis Software
	Nutritional Ingredients	Packaging Materials and/or Equipment
	Ingredient Systems	Process Equipment/Pumps/Valves/Air & Liquid Handling Equipment
	QA/QC Instrumentation & Software	None of the Above

Which of the following best describes your title? (select only one)

	Research & Development: President/VP of R&D, Food Tech, Scientist
	QA/QC: Quality Assurance Manager, Quality Control Manager
	General Management & Administration: Owner, President, Partner, General Manager
	Marketing: Category/Brand/Product Manager, Marketing Director
	Purchasing: Purchasing Director/Supervisor, Purchasing Agent, Buyer
	Sales: VP of Sales, Sales Director, Sales Manager
	Other
	Please specify for Other:

Does your company manufacture/develop food and/or beverages for: (select all that apply)

	Retail
	Food Service
	None of the Above

Would you like to receive a free copy of the Food Master annual catalog?

Yes     No

Please check you preferred format:

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In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. What is your date of birth?

Select Date of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

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I wish to receive a FREE subscription to Lab Manager Magazine®. Lab Manager Magazine® helps provide a forum and a framework to help lab professionals hire and supervise staff, establish a laboratory, and plan a coherent research program, while keeping the goals of good science and scientific discovery at the forefront. Most lab managers, by education and experience, are thoroughly capable of handling the technical aspects of their jobs, but their managerial skills are often obtained haphazardly. Lab Manager Magazine® is written with those managers in mind and has the distinct editorial mission of providing practical information on business, strategy, leadership and staffing as well as the industry and technology news needed to effectively manage today's lab. Note: Offer Valid in USA, Canada Only.

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Which best describes your organization's business / industry?

Select industry University or College Government Hospital or Medical Center Private Research Institution Contract Research Organization Clinic Research Lab Pharmaceutical Food and Beverage Biotechnology Environmental Energy Automotive Petroleum Security / Forensics Fine and Specialty Chemicals Other Industrial Labs Other Please Specify for Other:

Which best describes your job title?

Select job title Corporate Management (CEO, President, VP, etc.) Lab Supervisor / Manager / Director R&D Supervisor / Manager / Director Core Facility Director / Manager QA / QC Manager / Director Research Scientist Chemist Principal Investigator Project Director/Manager Engineer Academic - Department Head Academic - Professor Academic - Student Purchasing Agent Professional/Technical Consultant Other Please Specify for Other:

Do you specify, influence, recommend or buy laboratory products and services?

Yes     No

Please identify all of your areas of responsibilities within your organization. (select all that apply)

	Perform R&D Activities	Determine How to Gain Competitive Advantages Via Research Initiatives
	Evaluate New Approaches to Research Projects	Determine the Impact of Research Activities on Company's Business Strategy
	Identify Strategic Problems/Opportunities Relating to Research Projects	Select Areas of Investment to Enhance Research Operations
	Have Business Responsibilities Related to Research Projects	Evaluate and Make Capital Equipment Purchase Decisions
	Plan for Change/Growth in Research Projects	Other
		Please Specify for Other:

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