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CSP Subscription Form

* Required in order to receive a subscription for CSP Magazine
* First Name
* Last Name
* Title
* Company Name
Store Name (dba)
* Address 1
Address 2
* City
State/Province
Zip/Postal Code
Country
Phone()-
Fax()-
Email Address
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I would like to receive/continue to receive my FREE subscription to CSP Magazine.
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* For circulation auditing and verification purposes, CSP is required to ask the following question. This information is required and will not be shared.
On what day of the month were you born?
* What is your primary type of business?
Chain/Franchise/Petroleum marketer including headquarters, regional or district office
Convenience/Petroleum chain operated store
Single Store Headquarters
College Store
Distributor/Wholesaler/Broker
Discount/Mass Merchandiser/Club
Drug Stores
Military
Supermarket/Grocery
Supplier/Manufacturer of products/services for the convenience channel
Association
Consultant
Other (please describe) 
* Number of stores in your chain or business: (Check One Only)
  1
  2-3
  4-10
  11-50
  51-200
  201 or more
* What is your title? (Check One Only)
  Chairperson, CEO, Pres, Owner, Franchise, Partner
  COO, CFO, VP, Gen. Mgr.
  Supervisor, Regional or District Mgr., Operations Mgr.
  Buyer, Director, Merchandise Mgr., Category Mgr., Marketing Mgr., Sales
  Store Manager
  Other (please describe) 
* What is the average store's annual sales volume?
  More than $1 Million
  Less than $1 Million
Which of the following products or services do you specify, influence, recommend or buy? (Check All That Apply)
Tobacco
Non-Alcoholic Beverages
Alcoholic Beverages
Dairy Products
Snacks
Candy
Food Service
Grocery
General Merchandise/HBC
Fuel Equipment
Technology
Services (inc. Financial, ATM, Lottery, etc.)
Carwash
I DO NOT specify, influence, recommend or buy products and services
Please list the names, phone numbers, and titles of other people at your company who would be interested in receiving CSP Magazine.
First Name
Last Name
Email
Phone
Title
First Name
Last Name
Email
Phone
Title
First Name
Last Name
Email
Phone
Title
 
Free subscriptions are available to qualified recipients in the United States and Canada. Paid subscriptions are available to all others. The publisher reserves the right to limit the number of free subscriptions and set qualification criteria for a free subscription.