| |
| 1. | Do you wish to receive a FREE subscription to Applied Clinical Trials? |
Yes
No
Is this your home address?
Yes
No
Advanstar Communications provides certain customer contact data (such as customers' names, addresses, phone numbers and email addresses) to third parties who wish to promote relevant products, services and other opportunities which may be of interest to you. If you do not want Advanstar Communications to make your contact information available to third parties for marketing purposes, check below.
No, do not provide my contact data to third parties.
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) |
| 2. | My primary business is: (select only one) |
| 3. | My primary job function is: (select only one) |
| 4. | What is your involvement in the purchase of products or services for research or clinical trials? (select all that apply) |
| 5. | Would you also like to receive Applied Clinical Trial's quarterly e-newsletter, LabViews? |
Yes
| 6. | Would you also like to receive Applied Clinical Trial's quarterly e-newsletter, EDC News? |
Yes
| 7. | My job title is: (select only one) |
| 8. | To permit future verification of your request, please answer ONE of the following questions: What is your state of birth? OR What is your year of birth? |
| | 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. |
| | Category of Position: (select only one) |
| | Type of Organization: (select only one) |
| |
Job Title? (select all that apply) |
|
| |
Job Location? (select all that apply) |
|
| |
Work Area? (select all that apply) |
|
| |
Discipline? (select all that apply) |
|
| |
Products used in your laboratory? (select all that apply) |
|
| |
Check the exhibits/meetings you plan to attend? (select all that apply) |
|
| | What subscription delivery method do you prefer? |
NOTE - Print edition available in US and Canada only. Digital edition delivered via email.
Print
Digital
Both
Yes! I'd like to subscribe to Lab Manager Magazine's® weekly newsletter to read about the latest industry and technology news and trends.
Yes, I would like to receive emails from Lab Manager Magazine® and meticulously approved third parties announcing conferences, shows, products and services which are applicable to my needs as a lab manager.
Lab Manager Magazine® will not exchange, rent or release your email address to a 3rd party. Your email address will be used for renewal requests, digital edition and information from Lab Manager Magazine®'s parent company LabX.
| | Which best describes your organization's business / industry? (select only one) |
Please specify for Other.
| | Which best describes your job title? (select only one) |
Please specify for Other.
| | Do you specify, influence, recommend or buy laboratory products and services? |
Yes
No
| | Please identify all of your areas of responsibilities within your organization. (select all that apply) |
| | In order to verify your request for this publication, without the availability of a signature, LabX audit bureau requires a personal identifying question. This information is used solely for the purpose of auditing your request. What is your month of birth? |
| | Would you also like to receive the digital edition of BioPharm International? |
Yes
No
Is this your home address?
Yes
No
By providing your email address you consent to Advanstar Communications contacting you with relevant updates about products and services by email. Your email will not be passed to third parties. Information you supply to Advanstar Communications may be used for publication (where you provide details for inclusion in their directories or catalogues and on their website) and also to provide you with information about their products or services in the form of direct marketing activity by phone, fax or post. Information may also be made available to third parties on a list lease or list rental basis for the purpose of direct marketing. If at any time you no longer wish to a) receive anything from BioPharm International or b) have your information made available to third parties, please write to: Kris Baxter, Data Protection, Advanstar Communications, 131 West First Street, Duluth, MN 55802 or email fulfill@superfill.com and provide your complete name and delivery address.
| | What is your organization's primary business? (select only one) |
Please specify for Other:
| | What is your specific function? (select only one) |
Please specify for Other:
| | What is your job title? (select only one) |
Please specify for Other:
| | What special issues would you be interested in reading about in the future? (select all that apply) |
| | Would you like to receive BioPharm International's monthly electronic newsletter, The BioPharm International Science and Business Bulletin? (Your email address is required above) |
Yes
No
| | To permit future verification of your request, please answer the following question. |
 |
| | Security Check: Enter both words below, separated by a space. |
|
|