Equipment World Free Subscription

	*Equipment World* is free to qualified professionals. Summary Description
	To apply for a FREE digital subscription to *Equipment World*, 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 digital subscriptions.
	Geographic Eligibility: USA

1.	*Do you wish to receive a FREE digital subscription to Equipment World?*

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First Name:
Last Name:
Title:
	(Ex: Owner, Partner, Service Manager, Technician, etc.)
Company Name:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Street Address:
Dept/Mail Stop/Suite:
City:
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Zip:
Country:
	(Note: If your country is not listed above, distribution is not currently available at your location.)
Email Address:
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Fax Number:

By providing your fax number, email address, and personal id on this form you are agreeing to receive from Randall-Reilly Publishing Co. faxes or email pertaining to subscription renewal notices or forms, subscription information or advertising that may be of interest to you.

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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.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. On what day of the month were you born?

3.	Please check the primary business/function of your company/organization: (select only one)

1.A. FOR CONTRACTORS ONLY

Highway & Heavy Construction -- Contractors primarily engaged in construction of highways, streets and roads, bridges/overpasses and airports, underground construction, excavating, marine construction, demolition, water/sewer/related utilities, drilling and/or the construction of projects other than building erection

General Building Construction -- Contractors primarily engaged in construction of heavy buildings and tract development (not home builders)

Engaged in Both -- Contractors substantially engaged in both categories described above

Other Contractors -- Electrical, mechanical, and other contractors (please specify)

1.B. FOR NON-CONTRACTORS ONLY

Construction material producer (sand, gravel, stone, lime, cement, ready mix, asphalt)

Utility

Mining

Equipment rental

Dealer/Distributor of components, parts, supplies, and accessories

Manufacturer of Construction Equipment or Supplies

Other (please specify)

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

Upper Management: CEO's, Chairmen of the Board, Owners, Partners, Presidents, Vice Presidents, CFO's, Treasurers

Middle Management: Administrators, Managers, Supervisors, Superintendents, Master Mechanics, Engineers, Purchasing Agents, Other Executive Officials

Equipment Staff: Equipment Superintendents, Shop & Mechanical Supervisors, Fleet Superintendents, Estimators, and Heavy Equipment Operators

Other: Other titled and nontitled personnel and company addressed copies (please specify)

5.	What is your firm's annual CONTRACT or SALES VOLUME? (select only one)

More than $10 million $500,001 to $1 million

$5,000,001 to $10 million Less than $500,001

$1,000,001 to $5 million

6.	What is your firm's replacement value of CONSTRUCTION EQUIPMENT & TRUCKS owned and/or leased for your company's use? (select only one)

More than $10 million $500,001 to $1 million

$5,000,001 to $10 million Less than $500,001

$1,000,001 to $5 million

7.	In the performance of my job, I have the authority to specify, select, and/or approve acquisition of the following: (select all that apply)

Excavating, grading, and/or other types of earthmoving equipment Construction materials (cement, steel, pipe, ground support fabrics)

Materials producing and/or paving equipment Parts, components, and/or automotive accessories (engines, transmissions, tires, filters, hoses)

Lifting and hoisting equipment (cranes, lift trucks, hoists, derricks, concrete pumps) Forming, scaffolding and/or false work

Trucking and hauling equipment (on- and off-road trucks, haulers, pickups, mixers, truck bodies, trailers) Financing, Insurance and/or bonding

Maintenance equipment, tools and/or supplies Computer hardware/software

General utility equipment (compressors, pumps, generators, lighting, mixers) Attachments

Safety equipment and/or apparel None of the above

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