Direct Free Subscription

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

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First Name:
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	(Ex: Director, Vice President, Project Manager, etc.)
Company Name:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Department/Mail Stop:
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	(Note: Valid email address is required or you could be disqualified.)

^*Your email address is used to send order confirmation and to communicate to you about your subscription. Please check here if you DO NOT wish to receive:
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Yes, please auto-fill my contact information for other publication qualification forms.

What is the approximate number of employees in your company? (select only one)

2.	In lieu of a signature, we require a unique identifier used for subscription verification purposes by our auditing bureau. What is the city or town of your birth?

3.	Please check the one category that best describes your company: (select only one)

Advertising/Sales Promotion/Direct Marketing Agency or Consultant List Compiler/List Manager

Manufacturer (Excluding Hi-tech) Association/Fund Raising/Non-Profit Organization

Hi-tech: ISP, Computers, Telecommunications, Software Hospital/Health Care

Retailer Education/Seminars/Trade Shows

Instore Social Services

Mail Order Public Administration/Government

Instore and Mail Order Communication/Transportation/Utility

Electronic Banking/Insurance/Real Estate/Financial

Wholesaler/Distributor Entertainment/Hospitality/Travel

Publisher (Books, Magazines, Newspapers, Music or Video) Services (Consumer or Business) - (please specify)

List Broker

4.	My primary job function is: (select only one)

Corporate/General Management Fulfillment/Data Processing Management

Sales/Marketing/Telemarketing Management Mailroom/Operations Management

Advertising/Promotion Management Production/Creative Management

Circulation/List/Media Management Other (please specify)

5.	Which of the following types of media are used by your company and/or clients? (select all that apply)

Solo Mailings Publishing Media

Catalogs/Multi-Page Mailers Telemarketing

Free Standing Inserts/Coupons DRTV/Radio

Card Decks Electronic Commerce

Package/Co-ops Inserts

6.	I am involved with: (select only one)

Consumer Direct Marketing Both Consumer and Business to Business

Business to Business Direct Marketing

7.	Please check the approximate annual total direct marketing expenditures for your company and/or clients: (select only one)

Over $10 million $500,001 - $1 million

$5 million - $10 million Under $500,000

$1 million - $5 million

8.	I specify, recommend, approve, purchase or influence the purchase of: (select all that apply)

Database Marketing Services Distribution Services

Telemarketing Services Fulfillment Services

List/Related Services Sales Promotion

Printing/Related Services Financial Products/Services

E-Commerce Services Desktop Publishing Systems/Services

Paper Search Engine Marketing/Optimization

International Direct Marketing Services Equipment (please specify)

Lettershops/Mailing Services

9.	*If Direct* launches a digital edition in the future, would you like to receive your issues in this format rather than print?**

Yes No

10.

Please select the following newsletters that you would like to receive:

Direct Listline - Things change fast in the list business. That's why list pros at the industry's top companies turn to Direct Listline to stay up-to-date on what's new and what's changed.
Direct Newsline - Direct Newsline is the must-read daily e-newsletter from DIRECT that lets direct marketers respond to emerging opportunities fast.
Magilla Marketing - Magilla Marketing is a weekly e-newsletter that delivers the blunt truth on e-mail marketing, through honest and insightful commentary by editor and real-world direct marketer Ken Magill.

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Please indicate your industry: (select only one)

Please select your job title: (select only one)

Does your company have 1-300 employees?

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Is the mailing address on your subscription currently your home or business address?

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* Note that a valid email address is required to fulfill your request. Please verify that the email and mailing address you provided are accurate before hitting the submit button.

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