Pharmaceutical Technology Free Subscription

	*Pharmaceutical Technology* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Pharmaceutical Technology*, 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

1.	*Do you wish to receive a FREE subscription to Pharmaceutical Technology?*

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2.	To permit future verification of your request, please answer ONE of the following questions: What state were you born in? OR What high school did you attend?

3.	What is your company's primary business? (select only one)

Pharmaceutical Manufacturing Drug Delivery Devices & Instrumentation Manufacturing

Biopharmaceutical Manufacturing Government

Pharmaceutical Delivery Systems Consultant to Pharmaceutical Industry

Specialty Chemicals, Bulk Products and Raw Materials Producers Contract Research/Analytical/Manufacturing Services

Pharmaceutical Development Architecture/Engineering/Construction

University/Research Institute/Foundation Other (please specify)

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

Research and Development Materials Management/Purchasing

Quality Control/Assurance, Validation Information Technology

Lab Management Packaging

Production/Manufacturing Education/Teaching

Engineering Technical/Analytical Services or Support

Regulatory Affairs Project Management

Corporate Management Other (please specify)

Marketing/Sales Management

5.	Does your job title include Vice President, Director Manager, Supervisor, Group Leader or Department Head?

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6.	Does your job title include Engineer?

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7.	Does your job function include packaging?

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8.	Does your job title or function include the approval process for Contract Services?

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9.	Are you involved in buying, specifying, evaluating or recommending products or services for pharmaceutical research, development, or manufacturing?

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