Independent Provisioner Free Subscription

	*Independent Provisioner* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Independent Provisioner*, please answer ALL of the questions on the form below.
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	Geographic Eligibility: USA

1.	*Do you wish to receive a FREE subscription to Independent Provisioner?*

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

Processed/Further Processed Meat (fresh, frozen, canned, smoked, including beef, sausage, pork, lamb, veal and others)
Processed/Further Processed poultry (fresh, frozen, canned, smoked, including chicken, turkey and others)
Prepared Foods & Specialties (dinners, meals, entrees, shelf stable, including ethnic foods, soups)
Slaughtering, Fabricating, Cutting, Rendering (meat, poultry)
Other (please specify)

3.	Which of the following best describes your job title? (select only one)

General Management/Administration (President, Owner, Vice President, General Manager, Asst. Manager, Distribution Manager)

Plant Operations/Plant Production, Packaging, Engineering, Warehousing/Distribution (Plant Manager, Production Manager, Traffic Manager, Packaging Manager, Maintenance Manager, Engineer, Chief Project, Design, Systems)

Technical R & D, Quality Control (Technologist, Chemist, Scientist, Research Tech, Group Project & Research Specialist, QC/QA Manager)

Sales and Marketing (Director, Manager, Brand Assistant, Advertising)

Purchasing (Purchasing Director, Supervisor, Agent, Buyer)

Other (please specify)

4.	What is the number of employees at this location? (select only one)

150 or more 50-74

125-149 25-49

100-124 1-24

75-99

5.	Do you recommend, specify or buy the following? (select all that apply)

Processing Equipment Sanitation & Maintenance

Ingredients QA/QC, Instruments & control

Packaging Equipment Material Handling & Equipment

Packaging Materials Other (please specify)

Warehousing & Distribution None of the Above

6.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. How many letters are in your father's first name?

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