Machinery Lubrication Free Subscription

	*Machinery Lubrication* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Machinery Lubrication*, please answer ALL of the questions on the form below.
	The publisher determines qualification and reserves the right to limit the number of free subscriptions.
	Geographic Eligibility: USA (Digital & Print Version), Canada and Selected International (Digital Version Only)

1.	*Do you wish to receive a FREE subscription to Machinery Lubrication?*

Yes No

First Name:
Last Name:
Job Title:
	(Ex: Director, Vice President, Project Manager, etc.)
Business Phone:
Business Fax:
Email:
	(Note: Valid email address is required or you could be disqualified.)
Company:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Street Address:
Dept/Div:
City:
State/Province:
Zip:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)

Yes, please auto-fill my contact information for other publication qualification forms.

2.	Please check the appropriate category for your company. (select only one)

Power Generation Primary Metals

Mining Fabricated Metals

Rubber/Plastic Automotive Manufacturer

Food Processing Machinery Manufacturer

Transportation Electrical Equipment

Construction Transportation Equipment

Textiles Miscellaneous Manufacturing

Paper Engineering Services

Chemicals Military/Government

Petroleum Products Other

3.	What is the total number of employees at this location? (select only one)

2500 or More 250-499

1000-2499 100-249

500-999 99 or Less

4.	What is your primary job function? (select only one)

Engineering Quality Assurance

Engineering Mgt Operator

Maintenance Corporate Mgt

Maintenance Mgt Training

Lubrication Technician Other

Reliability

5.	Check ALL products and services you specify, recommend, buy or approve: (select all that apply)

Lubricants/hydraulic fluids Filters and/or filtration units

Lubrication systems Training

Lubrication hardware/fittings Test/diagnostic instruments

Lubrication software

6.	*How would you like to receive your copy of Machinery Lubrication?*

Print Digital

7.	In lieu of a signature, we require a personal identifier. To verify that you submitted this application please select below the month in which you were born. Month you were born:

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* 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.