FREE Subscription Form

Directions: Use Tab key to move through the fields below and space bar to make selections. You can also use the mouse to click through the choices.

 
  Yes! I wish to receive MASS MARKET RETAILERS.
  No, I do not.

In lieu of a signature, we require a unique identifier used only for subscription verification purposes.

 
What month were you born in?
First Name:
Last Name:
Title:
Company Name:
Dept/Mail Stop/Suite:
Address:
City:
State, Province or Territory:
Zip/Postal Code:
Country (if not USA)
Phone: (numbers only)()-
Fax: (numbers only)()-
E-mail Address:
Free subscriptions are available in the US and Canada only.
By providing your e-mail address, you are granting Mass Market Retailers permission to contact you regarding
your subscription. Please note, your e-mail address will not be shared with any third party. If you do not wish to
receive other e-mail promotions from Mass Market Retailer, check here 
1. What is your company's primary business (check one only):
HEADQUARTERS (CORP/REG/DIST) OF:
  Discount/Gen Mdse Store Chain
  Drug Store Chain
  Supermarket Store Chain
  Co-op, Voluntary or Wholesaler
  Wholesale/Warehouse Club
  Manufacturer or Mfr's Rep
  Association or Government Agency
  Other (Please specify) 
2. What is the total number of stores in your chain? (Retailers only)
  2-3 stores
  4-10 stores
  11 + stores
3. What is your title? (Check one only)
  Administrative/operations management (Owner, Pres, Partner, VP, GM, Treasurer, Dept Head, Mgr Supv, etc.)
  Buyer/Merchandise Mgr/Category Manager
  Other (Please specify) 
4. What is your primary area of responsibility? (check one only)
  Operations
  Sales/Marketing
  Loss Prevention
  Warehouse/Transportation
  Finance
  MIS/EDP
  Store Planning
  Merchandising
  Category Management
  Real Estate
  E-Commerce
  Other (Please specify) 
5. Do you recommend, approve or purchase any of the products listed below
(check all that apply)
 H&BA/Cosmetics
 OTC Drugs/Vitamins
 Rx Drugs/Generics
 Photo/Batteries
 Audio/Video
 Tobacco
 Greeting Cards/Stationery/Office Supplies
 Candy/Snacks
 Beverages
 Magazines/Books
 Jewelry
 Household/Petcare
 Housewares/Hardware
 Toys
 Automotive
 Seasonal
 Soft Lines
 Private Label
 Other
 None of the Above
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