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| 1. | Do you wish to receive a FREE subscription to Food Product Design? |
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| Job Title: |
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| Company: |
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(Please provide your Company Name in full: abbreviations could disqualify you) |
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(Note: Valid email address is required or you could be disqualified.) |
Yes, please auto-fill my contact information for other publication qualification forms.
| 2. | What is your company's primary business? (select only one) |
| Prepared Foods |
Bakery Products |
| Food Service, Fast Food, QSR |
Bread, Cakes & Related Products |
| Prepared Dinners, Meals, Side Dishes |
Cookies and Crackers |
| Frozen Specialties, Dinners |
Other Bakery Products |
| Meat |
Confectionery |
| Sausages/ Other Prepared Meats |
Candy & Confectionary |
| Poultry Processing |
Chocolate & Cocoa Products |
| Other Meat Products |
Chewing Gum |
| Dairy |
Other Confectionary Products |
| Creamery Butter |
Beverages |
| Cheese, Natural & Processed |
Malt Beverages |
| Condensed & Evaporated Milk |
Wines, Brandy & Brandy Spirits |
| Ice Cream & Frozen Desserts |
Distilled & Blended Liquor |
| Fluid Milk |
Bottled & Canned Soft Drinks |
| Other Dairy Products |
Flavoring Extracts & Syrups n.e.c. |
| Preserved Fruits & Vegetables |
Other Beverage Products |
| Canned Specialties |
Other Food Products |
| Canned Fruits & Vegetables |
Seafood Canned & Cured |
| Dehydrated Fruits, Veg, Soups |
Seafood Prepared Fresh/ Frozen |
| Pickles, Sauces, Salad Dressings |
Coffee Roasted/ Flavored |
| Frozen Fruits & Vegetables |
Potato Chips, Corn Chips & Snacks |
| Other Fruits & Vegetables |
Macaroni, Spaghetti, Noodles |
| Grain Mill |
Nuts & Seeds Salted/ Roasted |
| Flour, Dough, Prepared, Blended |
Shortening & Cooking Oil |
| Cereal Breakfast Foods |
Processed Food Ingredients |
| Dog, Cat & Other Pet Foods |
Other Food Prod & Food Preparations (please specify) |
| Prepared Feeds n.e.c. |
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| Other Grain Mill Products |
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| 3. | What is your job title? (select only one) |
| 4. | How many employees work at this location? (select only one) |
| 5. | For which of the following applications are your products/services used? (select only one) |
| 6. | Do you plan to introduce a new product or expand an existing product line in the next 24 months? |
Yes
No
| 7. | Which of the following products do you buy, specify, recommend or influence the purchase of for your company? (select all that apply) |
| 8. | In the performance of your job, in which of the following functions are you involved? (select all that apply) |
| 9. | In order to permit future verifications of your request for a free subscription, we need to ask you a personal identifier. What state were you born in? |
| 10. | Please select whether or not you would like to receive the Food Product Design e-newsletter. |
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| | Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com? |
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| | Sign up for special offer alerts from select partners featuring the latest products and services you are interested in. |
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| Related FREE Offers from TradePub.com: Check those you wish to receive. |
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Which of the following best describes your industry? |
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Please Specify for Other: |
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What is the approximate number of employees in your company? |
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What is the size of your health delivery organization? |
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Is your organization a: |
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Which of the following areas do you think would benefit your organization the most? |
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Company Employee Size: |
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Job Role/Title: |
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Microsoft may send me pertinent security, product, and event information via: (select all that apply) |
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You will receive subscription and renewal notices from BNP Media via email. |
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Check the category that best describes the primary product produced at your company: (select only one) |
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Prepared Foods & Specialties/Ingredients: Including prepared dinners/meals/entrees (incl. ethnic foods); prepared side dishes; baby foods; pizza; ready-to-eat breakfast foods; pet foods; ready-to-mix desserts (incl. gelatin); peanut butter and pasta. |
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Prepared Fruits & Vegetables/Ingredients: Including prepared fruits & vegetables, jams, jellies, preserves, soup & soup mixes; ketchup, sauces, gravies, condiments, seasonings, flavors & syrups; oils, salad dressing & mayonnaise, and pickled products. |
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Prepared Meat, Poultry & Seafood/Ingredients: Including prepared meat, sausage, poultry, eggs, and seafood products. |
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Dairy Foods/Frozen Novelties/Ingredients: Including cheese (imitation and natural); whipped toppings; margarine & butter, ice cream & frozen novelties; yogurt, cottage cheese, dips, sour cream, milk & milk substitutes. |
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Bakery Foods/Ingredients: Including sweet goods, pastries, pies, snack cakes, cookies; crackers, biscuits, breads & rolls; English muffins, bagels, croissants, breadsticks, etc. |
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Beverages/Ingredients: Including coffee & tea; non-carbonated beverages & beverage mixes; fruit & vegetable juices, carbonated beverages; wine, beer, liquor. |
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Snack Foods/Candy/Ingredients: Including potato chips, corn & other chips, pretzels, nuts, popcorn, granola bars, meat snacks, candy, gum, chocolate. |
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Manufacturer of Nutritional Supplements, Nutraceuticals and/or Ingredients |
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R&D Center or Headquarters of a Food and/or Beverage Manufacturer |
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Food Service |
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Universities |
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Independent R&D Labs, Government |
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Other |
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Please specify for Other: |
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In the performance of your job, in which of the following functions are you involved: (select all that apply) |
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What is the total number of employees at this location? |
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Check the products you buy, specify, recommend, or influence the purchase of for your company: (select all that apply) |
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Which of the following best describes your title? (select only one) |
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Research & Development: President/VP of R&D, Food Tech, Scientist |
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QA/QC: Quality Assurance Manager, Quality Control Manager |
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General Management & Administration: Owner, President, Partner, General Manager |
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Marketing: Category/Brand/Product Manager, Marketing Director |
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Purchasing: Purchasing Director/Supervisor, Purchasing Agent, Buyer |
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Sales: VP of Sales, Sales Director, Sales Manager |
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Other |
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Please specify for Other: |
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Does your company manufacture/develop food and/or beverages for: (select all that apply) |
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Please check you preferred format: |
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In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. What is your date of birth? |
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Number of persons employed by your organization: |
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Please indicate the extent to which you are involved in the purchasing decision for your employer's risk management and/or employee benefits products and services: |
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For purposes of verification, please provide the state you were born in: |
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| | Security Check: Enter both words below, separated by a space. |
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