| |
| 1. | Do you wish to receive a FREE subscription to HVACR Business? |
Yes
No
| First Name: |
|
| Last Name: |
|
| Job Title: |
|
| Company: |
|
| |
(Please provide your Company Name in full: abbreviations could disqualify you) |
| Address: |
|
| Dept/Mail Stop/Suite: |
|
| City: |
|
| State: |
|
| Zip Code/Postal Code: |
|
| Country: |
|
| |
(Note: If your country is not listed above, distribution is not currently available at your location.) |
| Phone: |
|
| Fax: |
|
| Email: |
|
| |
(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) |
| 2. | Do you wish to receive Ahead of the Curve E-Newsletter? |
Yes, I wish to receive Ahead of the Curve E-Newsletter.
No, thanks.
| 3. | Which category best describes your firm's business activity? (select only one) |
| 4. | Do you personally design, specify, recommend, or buy products for mechanical systems? |
Yes
No
| 5. | Which of the following types of work does your firm perform? (select all that apply) |
| 6. | Number of employees at this location? (Annual average includes myself) (select only one) |
| 7. | Which range properly describes your approximate annual sales volume? (select only one) |
| Under $100,000 |
$1,000,000 - $2,499,999 |
| $100,000 - $249,000 |
$2,500,000 - $4,999,999 |
| $250,000 - $499,999 |
$5,000,000 - $7,499,999 |
| $500,000 - $749,000 |
$7,500,000 - $9,999,999 |
| $750,000 - $999,999 |
$10,000,000 and over |
| 8. | Select one category below that best describes your job function. (select only one) |
| 9. | In which of the following is your firm involved? (select all that apply) |
| 10. | How would you like to receive future notices? (select all that apply) |
Fax
Email
Phone
| 11. | In order to verify your request for this publication, without the availability of a signature HVACR Business' audit bureau requires that they ask a personal identifying question. This information is used solely for the purpose of auditing your request. In what month were you born? |
| | Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com? |
Yes
No
| | Sign up for special offer alerts from select partners featuring the latest products and services you are interested in. |
Yes
No
| Related FREE Offers from TradePub.com: Check those you wish to receive. |
| |
Which of the following is closest to your job function? |
|
| |
Employees: |
|
| |
Primary business of your company or employer. (select only one) |
|
| |
Electrical Contracting/Low-Voltage Contracting - includes power (inside, line, lighting, maintenance, control etc.) electrical work, and/or all VDV, security, fire/life safety, fiber optics, home/building automation systems, and integrated building systems applications |
| |
Engineering/Architecture/Consulting |
| |
Systems Integration/Consulting |
| |
Wholesale/Distributor |
| |
Other |
| |
Please Specify for Other: |
| |
Primary job title or function: |
|
| |
|
| |
Please Specify for Other: |
| |
CHECK ALL of the Building Components you or your Company have installed. (select all that apply) |
| |
Total number of people who work for your company. (all locations combined) |
|
| |
CHECK ALL Construction Types you or your company have performed. (select all that apply) |
| |
What is your company's estimated total annual sales? |
|
| |
In lieu of a signature, National Electrical Contractors Association requires a personal identifier. To verify that you submitted this application please select below the month of your birth. What is the first letter of the city you were born in? |
|
| |
What is the number of employees in your entire organization? |
|
| |
 |
I wish to receive a FREE subscription to Industrial Hygiene News
- providing information to professionals in the Occupational Health, Industrial Hygiene and Safety fields. Industrial Hygiene News feature equipment and services to help keep the worker safe. Each issue has informational manufacturers' selection charts. Issue features include; First Response, Mold detection and remediation, Gas Detection, Heat Stress, Hazardous Material Handling & Cleanup, Skin protection, protective clothing, fall protection, ergonomics, radiation detection, indoor air sampling, respirators and noise measurement and protection.
Note: Offer Valid in US and Canada (print and digital editions).
|
| |
Which version would you prefer? |
|
| |
I am responsible for recommending, specifying, or purchasing: (select all that apply) |
| |
To permit future verification of your request by BPA (an independent circulation auditing firm) please give the state in which you were born: |
|
 |
| | Security Check: Enter both words below, separated by a space. |
|
|