American Painting Contractor
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A complimentary subscription to the print edition of American Painting Contractor will be sent to applicants who qualify. All questions must be answered completely. This offer is available to U.S. RESIDENTS ONLY. If your mailing address is outside the U.S., please call (570) 567-1982. The Publisher reserves the right to limit the number of free subscriptions.
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Account Number: 
Key Code: 
COMPANY ADDRESS:
First name
Last name
Title
Company name
Address
Address2
Country: USA
City
State
   Zip   
Business Telephone
Business Fax
E-Mail Address
QUALIFICATION FORM
Please answer ALL of the following questions:
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Digital Print

Digital is the full, interactive electronic version of the magazine that you can read on the web. Choose digital format for quickest delivery. 

1. What is your firm's primary business? (Check only one):
Please complete section 1 or 2. Contractors, please complete the annual sales volume as well.
1. CONTRACTOR
Residential Painting/Wallcovering
Commercial Painting/Institutional Painting/Wallcovering
Industrial Painting
   CONTRACTOR ANNUAL SALES VOLUME
   Under $50,000
   $50,000 - $99,999
   $100,000 - $249,999
   $250,000 - $999,999
   Over $1 million
2 OTHER RELATED INDUSTRY PROFESSIONALS
Manufacturer/Supplier
Other(Please Specify):
2. Which of the following products do you plan to buy? (Check all that apply):
Airless Paint Sprayer
HVLP Unit
Pressure Washer/Accessories
Ladders
Scaffolding
Wallcovering Pasting Maching
Respirators
Brushes/Rollers
None of the Above
3. What is your job title? (Check only one):
Owner/President
Supervisor/Manager
Foreman
Estimator
Painter
Other(Please Specify):
To permit future verification of your request by BPA (an independent circulation auditing firm) please give us your response to the personal identifying question below. This information is used solely for the purpose of auditing your request.

In what state was the last school that you attended?
*The personal identifying question is asked for when we are unable to obtain a signature. If you do not wish to provide us with the answer to the personal identifying question please download the following PDF  form and print it out and fax it back to us. APCFreeForm.pdf
   

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