| |
| 1. | Do you wish to receive a FREE subscription to Vision Systems Design? |
Yes
No
| 2. | I want to receive/continue to receive Vision Systems Design E-Newsletter FREE of charge. |
Yes
No
| First Name: |
|
| Last Name: |
|
| Job Title: |
|
| |
(Ex: Director, Vice President, Project Manager, etc.) |
| Company: |
|
| |
(Please provide your Company Name in full: abbreviations could disqualify you) |
| Address: |
|
| Department/Mail Stop: |
|
| City: |
|
| State/Province: |
|
| Zip/Postal Code: |
|
| Country: |
|
| |
(Note: If your country is not listed above, subscriptions are not currently available at your location.) |
| Phone: |
|
| Fax: |
|
| |
By providing your fax number, you are agreeing to receive fax broadcasts from PennWell. |
| Email Address: |
|
| |
(Note: Valid email address is required or you could be disqualified.) |
Occassionally we send our subscribers email special offers from relevant businesses/organizations. If you do NOT want to receive such offers, please check here.
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) |
| 3. | How would you like to receive Vision Systems Design? |
Printed
Digital
| 4. | Please indicate your principal job function: (select only one) |
| 5. | What INDUSTRIES do you design, develop, integrate, or manufacture vision systems for? (select all that apply) |
| 6. | What APPLICATIONS do you design, develop, integrate, or manufacture vision system products, vision systems, or vision subsystems for? (select all that apply) |
| 7. | I purchase, recommend, or specify the following products: (select all that apply) |
 |
| 8. | Which of the following best describes your job responsibilities? (select only one) |
| 9. | Which of the following publications do you personally read? (select all that apply) |
| 10. | Besides yourself, how many other individuals read your copy of Vision Systems Design regularly? (select only one) |
| 11. | How much does your company spend annually on imaging/vision products? (select only one) |
| 12. | Audit Verification (Required). In lieu of a signature, we require a personal identifier. To verify that you submitted this application please specify the last digit of the year you were 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 services does your company provide? (select only one) |
| | What is your job function? (select only one) |
|
|