Electronic Retailer Magazine Free Subscription

	*Electronic Retailer Magazine* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Electronic Retailer Magazine*, 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, Canada, Mexico, Europe, South America, China, Japan, Taiwan, Korea, Australia, South Africa, and Israel

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2.	Are you a member of the Electronic Retailing Association?

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5.	Electronic Retailer Magazine is an audited publication. Please answer the following question to secure that this subscription will be delivered to your name and address only. What is your eye color?

6.	How many people are employed by your company? (select only one)

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8.	If applicable, how many people do you manage? (select only one)

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9.	What segment of electronic direct marketing or retailing interests you? (select all that apply)

Media Buying Interactive Media

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Production Online Marketing

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Agency Services

10.

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Retailer Agency

Fortune 500 Company Media Buyer

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Internet Retailer Inventor

Service Provider

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