| |
| 1. | Do you wish to receive a FREE subscription to Area Development? |
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/Division: |
|
| City: |
|
| State: |
|
| Zip/Postal Code: |
|
| Country: |
|
| |
(Note: If your country is not listed above, subscriptions are not currently available at your location.) |
| Phone: |
|
| Fax: |
|
| Email Address: |
|
| | Which of the following best describes your industry? (select only one) |
Please specify for Other:
Yes, please auto-fill my contact information for other publication qualification forms.
| 2. | Which of the following apply to your company? (select all that apply) |
 |
| 3. | Number of employees in your company: (all locations) (select only one) |
| 4. | Please indicate your title: (select only one) |
| Chairman, President, Partner, CEO, COO, or Owner |
| VP, Treasurer, Controller, Security, or Other Corporate Officer (OCO) |
| CoreNet Member/Real Estate Manager/Director, Facilities Manager/Director, Development Manager/Director or VP Real Estate |
| VP Human Resources, Manager HR, Energy Manager, or Corporate Manager |
| Architect, Engineer, or Consultant |
| Other (please specify) |
| 5. | Concerning new facilities and site selection, would you be involved in the: (select all that apply) |
| 6. | In lieu of a signature, please answer the following personal identifying question. What is the name of the high school you attended? |
| | 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. |
| |
 |
I wish to receive a FREE subscription to Marine Log -
published since 1878, it covers the commercial marine industry worldwide- America's most respected marine industry monthly, and is dedicated to providing marine industry professionals with the information they need to enable them to design, build and operate vessels, rigs and offshore structures, profitably, safely, legally and in an environmentally responsible manner.
Marine Log serves the fields of vessel operations, ownership and management; shipyards and ship repair yards; naval architectural firms, marine engineering firms, marine consultants; port authorities and terminals; Navy, Coast Guard and other governmental agencies operating vessels; marine finance, marine insurance and maritime law. Qualified industry personnel are eligible to receive free subscriptions. These include executive and technical personnel, operational and financial personnel, purchasing and sales/marketing personnel.
Marine Log is a publication of Simmons-Boardman Publishing, New York.
Note: Offer Valid in USA, Canada, Mexico (Print and Digital available), International (Digital version only).
|
| |
Which business/industry best describes your company? (select only one) |
|
| |
Vessel Operations, Ownership & Management of: Ships, Boats, Barges, Cruise Vessels, Cargo Ships, Crew Boats, Ferries, Tugs, Research & Survey Vessels, Supply Boats, Dredges or Pushboats in oceans, harbors and inland rivers; including Offshore Drilling Companies |
| |
Shipyards & Ship Repair Yards: Shipbuilding Companies, including ship repair yards, repair subcontractors and newbuilding organizations |
| |
Naval Architecture Firms: Marine Engineering Firms, Other Technical Consultancy Firms including Surveyors and Classification Societies |
| |
Port Authority or Terminals |
| |
Navy, Coast Guard or other Gov't. Agencies operating vessels |
| |
Marine Finance, Marine Insurance and Marine Law Including P&I Clubs and Admiralty Law Firms |
| |
Allied Industries; Manufacturers, Suppliers and Distributors to the Marine Industry |
| |
Third Parties: NVOCC, Charterers, Brokers & Freight Forwarders |
| |
Industry Association |
| |
Manufacturer of major vessel infrastructure components |
| |
Others allied to the field. |
| |
Please specify for Other: |
| |
Which category best describes your job title? (select only one) |
|
| |
Executive Personnel including Owners, Partners, Presidents, CEO's, COO's, Vice Presidents, Directors, General Managers and other Executive personnel |
| |
Technical Personnel including Engineers, Surveyors, Inspectors, Analysts, Scientists, Chemists, Consultants, Naval Architects, and other Technical Personnel |
| |
Operational & Security Personnel include Marine Superintendents, Port Captains, Superintendent and Port Engineers, Shipyard Production Managers, Supervisors and other Operational & Security Personnel |
| |
Financial Personnel including Controllers, CFO's, Accountants, Estimators & other financial personnel |
| |
Purchasing Personnel including Buyers, Purchasers, Acquisition Managers, Materials Managers and other purchasing, acquisition and materials personnel |
| |
Sales and Marketing Personnel including Marketing & Public Relations Managers and other sales & marketing personnel |
| |
Other |
| |
Please specify for Other: |
| |
What type(s) of vessels is your company involved with? (select all that apply) |
|
| |
What is your role in the purchasing process? (select all that apply) |
|
| |
Which Marine Markets are you involved with? (select all that apply) |
|
| |
As proof to Simmons-Boardman Publishing's auditors that you have requested to receive their magazine, please indicate in which State/Province you were born. |
|
| |
Number of persons employed by your organization: |
|
| |
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: |
|
| |
For purposes of verification, please provide the state you were born in: |
|
| |
If Motorcoach Operator, please check all areas that apply to your business: (select all that apply) |
|
| |
Please choose one category that best describes your job function: |
|
| |
|
| |
Please specify for Other: |
| |
What is the number of people employed by your company/agency: |
|
| |
How many buses are in your company's fleet: |
|
| |
Annual Sales: |
|
| |
Please indicate your purchasing authority: |
|
| |
In order to verify your request for this publication without the availability of a signature, Power Trade Media asks a personal identifying question. This information is used solely for the purpose of auditing your request. What is your birth month? |
|
| | Business Classification: (select only one) |
GOVERNMENT EMPLOYEES: Please check the level of government in which you are employed.
City and Municipality
Township, Town and Special District (with road jurisdiction)
County (with road jurisdiction)
State (Highway and Toll Road)
Federal
PRIVATE INDUSTRY EMPLOYEES: Please check below a category which best describes your firm.
Contractor
Engineering Consulting
Producer
Other
Please specify for Other.
| | If your firm is a contractor or consulting engineer firm, please check all activities in which your firm is involved: (select all that apply) |
| | Job Title: (select only one) |
Government Administrators - Mayor, City/Town/Village Manager, Administrator, Commissioner, Council Member, Director, Superintendent/Supervisor Public Works, Health, Service, Safety Officials, City/County/District Engineer, Clerk, Airport Manager, Engineer, other Government Administrator.
Corporate Management - President, CEO, Chairman, Owner, Partner, Exec/Senior VP, VP, Secretary, Treasurer, Financial Officer, Financial, Purchasing Manager, Office, Branch Manager, other Corporate Manager.
Operations - General Manager, Director, VP, Manager (Area, Factory, Plant, Product, Division), Supt. of Streets, Highway/Road Supt., Project Engineer, Maint. Supt., Supervisor, Foreman, Operator, Chief Operator, Equipment Operator, other Operator.
Engineering - Vice President, Director, Managing, Chief, Senior, Resident, Staff, Sanitary, Design, Mechanical, Architect, Estimator, Electrical, Chemical, Maintenance, Civil, Structural, Field, Construction, Environmental, EPA, Safety, Traffic, Highway, Road, Consulting, other Engineer.
Technical - Research, Scientist, Biologist, Chemist, Analyst, Environmental and Pollution Control Spec., Tech. Mgr., Supt. Supv., Foreman, other Technician.
Marketing & Sales - Manager of Marketing/Sales, other Sales/Marketing Person.
Other
Please specify for Other.
| | Buying Authority: In the performance of my job I have the authority to specify, select or approve the acquisition of the following: (select all that apply) |
| Earthmoving, excavating, grading and related equip. |
Bridge deck and rail crossing pads. |
| All paving, planning and recycling equipment systems including breakers and compactors. |
Bridges & viaduct structural components & materials. |
| Lifting and hoisting equip. for shop and/or field. |
Computers - Hardware (including workstations, printers, plotters, peripherals) and Software (including CAD, GIS and scheduling). |
| Road maintenance equipment, mowers, plows, sweepers, spreaders and accessories. |
Equipment Leasing/Rental. |
| Trucks, trailers and hauling equipment. |
Financing/Insurance. |
| Road construction materials, including additives, emulsions, sealants, surface treatments, geotextiles. |
Design/Consulting/Engineering Services. |
| Herbicides, applicators and chemicals. |
ITS Technology/Equipment/Services. |
| Lighting, poles, posts, striping, signs and supports, and other road and traffic safety equipment. |
Stormwater/Erosion Control Products |
| Compressors, welding equip., generators, pumps & other general utility equip. for shop and/or field. |
None of the Above |
| Engines, components, parts, equip. maintenance, tools, replacement elements and lubricants. |
|
| | In order to verify your on-line subscription request, Scranton Gillette Communications is required to ask a personal identifying question. This information is used SOLELY for the purpose of auditing your request. What is the first inital of your father's name? |
 |
| | Security Check: Enter both words below, separated by a space. |
|
|