CustomRetailer Free Subscription

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

Yes No

First Name:
Last Name:
Job Title:
	(Ex: Director, Vice President, Project Manager, etc.)
Company Name:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Dept/Mail Stop/Suite:
Address:
City:
State, Province or Territory:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
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Email Address:

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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.	Is your company involved in custom installations?

Yes No

3.	What is your primary business? (select only one)

Custom Installer AV Consultant

Retailer Manufacturer's Rep

System Integrator Broadband Service Provider

Builder/Developer/Architect Other (please specify)

Distributor

4.	What is your primary job function? (select only one)

Business Management Sales Staff

Systems Design/Installation Management Contracting/Architecture

Systems Design/Installation Staff Project Management

Buying Consultant

Sales/Marketing Management Other (please specify)

5.	What type of products and services do you specify/recommend and/or purchase? (select all that apply)

Alarm Systems Mobile Electronics

Access Control Monitoring Services

Audio Components Power Protection

Audio/Video Distributions Satellite Systems

Cable, Fiber Wire & Connectors Software

CCTV Systems Structured Wiring Systems

Central Vacuum Telephone & Intercom

Computers Video Components

Furniture Lighting Control

Home Control/Automation Window Covering Controls

Home Networks Other not listed (please specify)

Home Theater

HVAC Control None

6.	Which of the following markets does your company serve? (select only one)

Residential Commercial Both None

7.	Please check the total annual custom installation sales volume of your company. (select only one)

Over $10 million $500,000 to $999,999

$5,000,000 to $9,999,999 $250,000 to $499,999

$1 million to $4,999,999 Less than $250,000

8.	*Would you like to receive CustomRetailer* E-Weekly, a FREE weekly email newsletter?**

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9.	*How would you like to receive your copies of CustomRetailer?*

Print Digital Both

10.

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Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com?

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