E&P (Hart's E&P) Free Subscription

	*E&P (Hart's E&P)* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *E&P (Hart's E&P)*, please answer ALL of the questions on the form below.
	The publisher determines qualification and reserves the right to limit the number of free subscriptions.
	Geographic Eligibility: USA, Canada (Print & Digital Versions available), Selected International (Digital Version only)

1.	*Do you wish to receive a FREE subscription to E&P (Hart's E&P)?*

Yes No

2.	*How would you prefer to receive E&P (Hart's E&P)?*

Print Digital (why choose digital?)

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)
Address:
Address 2: (Non USA/Canada)
City:
State, Province or Territory:
Zip/Postal Code:
Country: (if not USA)
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Phone: (numbers only)
Foreign Phone: (if not USA)	Please include city and/or country code
Fax: (numbers only)
Foreign Fax: (if not USA)	Please include city and/or country code
Email Address:
	(Note: Valid email address is required or you could be disqualified.)

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)

By providing your email address and/or fax number, you are granting Hart Energy Publishing permission to contact you regarding your print/digital subscription to E&P (Hart's E&P) magazine and other Hart Energy Publishing products and services.

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3.	Check the one job function most applicable to you: (select only one)

Executive Management (CEO/President/Owner/VP/Managing Director, etc.) Engineering

Exploration Management Field Professionals (Superintendent/Foreman/Toolpusher)

Engineering Management Purchasing

Geology & Geophysics Other (please specify)

Land

4.	Do you work in an asset team? (select only one)

Yes No Not applicable

5.	What does your company do? (select only one)

Major Integrated Oil & Gas Company Service Company

Independent Oil & Gas Producer Consultant or Consulting Firm

National/State Oil Company Supply Company

Integrated Service Contractor Insurance or Financial Services

Main Contractor or Subcontractor Educational Inst./Government Agency/Research Laboratory

Drilling Contractor Other (please specify)

6.	Where do you operate?

Onshore Offshore Both

7.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. What city were you born in?

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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.