Human Resource Executive Free Subscription

	*Human Resource Executive* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Human Resource Executive, please answer ALL of the questions on the form below. If you qualify, you'll receive a free, 6 month trial subscription to Human Resource Executive*, the premier publication focused on strategic issues in HR.
	The publisher determines qualification and reserves the right to limit the number of free subscriptions.
	Geographic Eligibility: USA, Canada, Mexico

1.	*Please start my free 6 month trial subscription to Human Resource Executive* (No payment information is required at this time).**

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2.	By providing your email address you are granting Human Resource Executive permission to contact you regarding your subscription. May Human Resource Executive use this email address to contact you about other product offerings?

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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:
Dept/Division:
City:
State/Province:
Zip/Postal Code:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Phone:
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Email:
	(Note: Valid email address is required or you could be disqualified.)

Is the above your business address?

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

3.	Primary business at this location: (select only one)

Agriculture, Forestry and Fishing

Mining/Construction (contractors, builders)

Manufacturing Distribution

Transportation, Communication, Electric, Gas and Sanitary Services

Wholesale/Retail Trade (restaurants, chain stores)

Finance, Insurance and Real Estate

Services (consultants, schools, universities, hotels, ad agencies, hosp., med services)

Public Administration (federal, state and local governments, military)

Other (please specify)

4.	Indicate your title: (select only one)

CEO, President, Chairman, Owner, Partner, Principal (insurance industry)

Vice President/HR

Assistant or Associate VP/HR

VP: Personnel, Staffing, Training, Employee Benefits, Financial, HRIS or Other

Asst/Assoc VP: Personnel, Staffing, Training, Employee Benefits, Financial, HRIS, or Other Asst/Assoc

Director: HR, Personnel, Training, Employee Benefits, Financial, HRIS or Other

Manager: HR, Personnel, Training, Employee Benefits, Financial, HRIS or Other

Consultant

Other (please specify)

5.	Number of employees in your entire company at all locations: (select only one)

25,000 or More 1,000-1,999

10,000-24,999 500-999

5,000-9,999 150-499

2,000-4,999 Under 150

6.	Has all or some purchasing and/or functional responsibilities for: (select all that apply)

Recruitment Services (including advertising) Testing, Appraisal and Evaluation Services

HR Related Software And Technology Meeting Sites

Relocation Services Safety and Security

Outplacement Services Food/Cafeteria Services

Insurance Benefits Temporary Services

Consultants Personnel Benefits etc Worker's Compensation

Training/Motivation None of the above

Recognition Awards/Incentives

7.	For purposes of verification, What is your mother's maiden name?

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