Advanced Imaging Free Subscription

	*Advanced Imaging* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Advanced Imaging*, 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 (Print or Digital Edition), Canada, Mexico, and Selected International (Digital Only)

1.	*Do you wish to receive a FREE subscription to Advanced Imaging? Note: International subscribers may receive an electronic version for free.*

Yes No

2.	*How would you like to receive your copy of Advanced Imaging?*

Electronic (USA, Canada, Mexico and Selected International) Print (USA Only)

First Name:
Last Name:
Job Title:
	(Ex: Director, Vice President, Project Manager, etc.)
Company Name:
	(Please provide your Company Name in full: abbreviations could disqualify you)
Mailing Address:
City:
State/Province:
Zip/Postal Code:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Phone Number:
Cell Phone Number:
	For subscription renewal only.
Fax Number:
	By providing your fax number, you may receive publication related information via phone or fax.
Email:
	(Note: Valid email address is required or you could be disqualified.)

Do you wish to receive Product or Service information from Cygnus Business Media's Industry partners via email? Yes No

What is the approximate number of employees in your company? (select only one)

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

3.	In order to verify your request for this publication, without the availability of a signature, Cygnus Business Media's audit bureau requires that they ask a personal identifying question. This information is used solely for the purpose of auditing your request.

What date of the month were you born?

4.	What is your firm's primary business activity? (select only one)

USER of imaging products, equipment, systems in:

Industrial Firm (including areospace, defense/military contractor, electronics, semi-conductor, process industry, automotive)

Commercial Firm (including publishing, media services, financial services)

Law Enforcement, Forensics, Security

Government, Military

University, Educational Institution, Research Laboratory

Medicine (including teaching and research)

MANUFACTURER/RESELLER of imaging products, equipment, or systems:

Original Equipment Manufacturer

Systems Integrator, Consultant, VAR, Dealer, Distributor

Other (please specify)

5.	Which category best describes your job title? (select only one)

Corporate Management (including CEO, President, Owner, VP, COO, CFO, Chairman, Director & related personnel)

Engineering Management (including VP of Engineering, Senior, Principal, Chief or Managing Engineer & related personnel)

Operations & Production Management (including VP, Manager, Supervisor or Head of Operations, Production or Manufacturing, General Manager, Dpt/Div. Head & related personnel)

Research & Development and Design Engineering Staff (including R&D or Design Engineer, Designer, Scientist, Analyst, Researcher & related personnel)

Application, Manufacturing & Production Engineering Staff (including Application, Manufacturing or Production Engineer & related personnel)

Consultant, Educator, Trainer

Technical & Creative Imaging Support Staff (including Technician, Imaging Specialist & related personnel)

Other (please specify)

6.	Do you have purchasing, recommending, specifying, or approval authority for the purchase of electronic imaging products?

Yes No

7.	Do you buy, specify or approve the purchase of the following electronic imaging core technologies? (select all that apply)

Illumination (including fiber optics, LEDs, etc.)

Optics (including lens, filters, etc.)

Backplanes (including CCD sensors, CMOS sensors, IR sensors, etc.)

Camera/Sensors

Datapath (including Fire Wire, GigE, CameraLink, USB, routers, etc.)

Processing (including PCI boards, FPGA, frame grabbers, DSPs, etc.)

Display (including flat panel, LCD, CRT, LEDs, microdisplays, etc.)

Storage (including DVR, RAID, SAN, etc.)

Software (SDKs, analysis, processing, language development, etc.)

None of the above

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

Security Check: Enter both words below, separated by a space.

* 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.