Please complete the qualifying information form below if you are interested in receiving a FREE subscription to Food Safety Magazine.
International subscribers will receive the digital edition.

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Part 1 - Personal Details
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First Name *
 

Last Name *
 

Title*
 

Company Name *

 

Address Line 1 *

 

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Zip or Postal Code *

 

Country*
   
 

Phone Number

 

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Email Address *

     

In order to verify your request for this subscription without the
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personal identifying question.

This information is SOLELY for the purpose of auditing your request.
     
  What is the month
of your birth? *
     

Part 2 - What is your primary Job Function? * 
   
 
   
   (If other, please specify*)
   

Part 3 - Which best describes your company? *
   
 
   
    (If other, please specify*)
   
   

Part 4 - Please indicate your principal products manufactured/services offered.  (check all that apply)
   
  - A. Meat
- B. Poultry
  - C. Fish/ Seafood
  - D. Eggs
  - E. Dairy Products
  - F. Fruits/Vegetables
  - G. Grain/Milled Products/Cereal
  - H. Baked Goods
  - I. Sugar/Confectionery
  - J. Ingredients
  - K. Fats/Oils
  - L. Beverages
  - M. Flavors
  - N. Misc. Foods (Coffee, Teas, Spices, Snack Foods, Condiments)
  - O. Wine / Beer
  - P. Prepared Foods
  - Z. Other (please specify*)
  - None of the above.
   

Part 5 - Indicate your purchasing plans for the next 12 months.
(check all that apply)
   
  - A. Analytical Instruments
- B. Audits/Training/Certification
  - C. Food Microbiology/Chemistry Testing Services
  - D. Packaging Equipment & Test Systems
  - E. Processing Equipment & Supplies
  - F. Foreign Materials Detection Systems
  - G. Hand Washing Equipment and Cleansers
  - H. Hygiene Testing, Monitoring and Control
  - I. Irradiation/ Sterilization
  - J. Laboratory Equipment & Supplies
  - K. Pathogen Reduction Technologies÷Non-Thermal
  - L. Pathogen Reduction Technologies÷Thermal
  - M. Pest Control
  - N. Rapid/Automated Microbiology Systems
  - O. Rheometers/Viscometers
  - P. Sampling Devices
  - Q. Sanitation Systems and Supplies
  - R. Sanitizers and Cleaners
  - S. Software and LIMS
  - T. Time/Temperature Equipment
  - U. Meters÷Water Activity/pH
  - V. Water Testing
  - Z. Other (please specify)
   
   

Part 6 - Additional Information / Requests.
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