MOTOR Magazine Free Subscription

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

1.	*Do you wish to receive a FREE subscription to MOTOR Magazine?*

Yes No

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)
Department/Mail Stop:
Street Address:
City:
State:
Zip Code:
Country:
	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Email Address:
	(Note: Valid email address is required or you could be disqualified.)
Business Phone:
Business Fax:

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.

2.	*In what format would you like to receive MOTOR Magazine?*

Print Digital

3.	Type of automotive business? (select only one)

General Repair Shop New Car or Truck Dealer

Diesel Repair Shop Gasoline Service Station doing Repair

Specialty Repair Shop Auto Service Dept. Retail Chain, Discount or Dept Store

Exhaust System Repair Tire Dealer with Service Bays

Transmission Repair Auto Parts Retailer

Radiator Repair Fleet

Brake, Front End, Wheel Alignment Vocational School

Automotive Electrical Repair Other (please specify)

Carburetor, Fuel Sys. Repair

4.	Title: (select only one)

Owner/Manager Mechanic/Technician

Service Manager/Foreman Other (please specify)

5.	Number of mechanics/technicians employed at this location? (please specify number)

6.	Number of service bays at this location? (please specify number)

7.	Vehicles serviced at this location? (select all that apply)

Domestic cars & light trucks Medium Duty Trucks

Import cars & light trucks Heavy Duty Trucks

8.	Repair work done at this location? (select all that apply)

Brake System Wheel Alignment

Battery Sales/Service Automatic Transmission Service/Overhaul

Oil/Filter/Lube Manual Transmission Service/Overhaul

Engine Performace/Driveability/Emissions Electrical System Service

Cooling System Service Engine Repair/Overhaul

Air Conditioning System Service Paint & Body Repair

Shock/Steering/Suspension Radiator Repair

9.	For which of the following products do you have purchasing influence? (select all that apply)

Replacement Parts Business Use Vehicles

Equipment & Tools (Diagnostic Equipment, General or Special hand tools) Business Equipment, Service & Supplies (PC Hardware/Software, Credit, Financial Services, General Office/Business Supplies)

Shop Supplies & Equipment None of the above

10.

Which of the following magazines are received at this location? (select all that apply)

MOTOR Age Brake & Front End

MOTOR Service Underhood Service

Import Car Professional Tool & Equipment News

Undercar Digest None of the above

11.

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* The publisher reserves the right to limit the number of free subscriptions and/or reject requests based on information provided.