Restoration & Remediation Free Subscription

	*Restoration & Remediation* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Restoration & Remediation*, 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 subscriptions.
	Geographic Eligibility: USA

1.	*Do you wish to receive a FREE subscription to Restoration & Remediation?*

Yes No

2.	Please check your preferred format: (select only one)

Print Version of Restoration & Remediation (FREE) Digital Version of Restoration & Remediation (FREE)*

*All digital subscribers will receive the print version until digital is available.

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)
Business Address:
Dept/Mail Stop/Suite:
City:
State/Province:
Zip/Postal Code:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Email Address:
	(Note: Valid email address is required or you could be disqualified.)
Phone:
Fax:
	You will receive subscription and renewal notices from BNP Media via email.

3.	Optional: If you want delivery to your home or Business P.O. Box, please complete the area below.

Please mail my copy to: Home (below) P.O. Box (below) Business Address (above)

Home Street Address or P.O. Box:
City:
State/Province:
Zip/Postal Code:
Country:

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.

4.	In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. How many letters are in your father's first name?

Your fax number is used to communicate to you. By providing your fax number, you are giving your written permission to receive subscription and other related information from BNP Media that may be of interest to you by fax. We will not share this information or use it for any other purpose. Would you like to receive subscription faxes sent by Restoration & Remediation/BNP Media?

Yes No

6.	*Would you like to receive the Restoration & Remediation* e-newsletter FREE of charge?**

Yes No

7.	Your primary business activity: (select only one)

Water Damage Restoration Property/Facility Management

Smoke/Fire Damage Restoration Laboratory Services

Mold Remediation Distributor

Indoor Environmental Professional Manufacturer's Rep/Sales Agent

Insurance Claims/Risk Management Other (please specify)

8.	Your primary job function: (select only one)

Owner/President Asset/Loss Management

General Management Sales

Restoration/Remediation Technician Other (please specify)

Project Manager

9.	Your purchasing authority: (select only one)

Approve/Purchase Recommend

Specify None of the above

10.

Your annual sales volume: (select only one)

More than $10,000,000 $500,001 - $1,000,000

$5,000,001 - $10,000,000 $250,001 - $500,000

$1,000,001 - $5,000,000 Up to $250,000

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

You Specialize In: (select all that apply)

Your Primary Business/Industry:

Please Specify for Other:

Your Job Title:

Please Specify for Other:

During Peak Season, Your Firm Employs the Following Number of People:

What is your company's primary field of work?

I wish to receive a FREE subscription to Underground Construction. For Underground Construction professionals involved in the construction and rehabilitation of pipeline and cable systems. Underground Construction serves the Underground Construction field which includes contractors, engineers, and utility company personnel engaged in the construction and rehabilitation of municipalities (water/wastewater) including local, state, and federal government; gas distribution and transmission systems, telephone and electronic companies. Note: Offer Valid in the United States and Canada Only.

How would you like to receive your copy of Underground Construction?

Print Digital

Please select the category which best describes your company's activity.

Please specify for Other.

Please select your job title/job function.

Please specify for Other.

My company is involved in trenchless construction methods.

Yes No

What is your company's annual construction volume?

What is the estimated replacement value of equipment owned?

May Underground Construction use email to contact you about other product offerings?

Yes No

What city were you born in? (This question acts only as a verification to confirm that you personally requested the subscription.)

Security Check: Enter both words below, separated by a space.

* 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.