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QUALIFICATION FORM

Incomplete forms will not be processed. A complimentary subscription to Electrical Contractor will be sent to those applicants who qualify. The publisher reserves the right to limit the number of subscriptions accepted.

1.	I wish to receive Electrical Contractor FREE of charge.

Yes!

No

NOTE: In order to be considered for a subscription to Electrical Contractor, you MUST select Yes above. If you do not select Yes, you will not receive a complimentary subscription to Electrical Contractor.

2.	Primary business of your company or employer. (Check ONE only)

Electrical Contracting/Low-Voltage Contracting - includes power (inside, line, lighting, maintenance, control etc.) electrical work, and/or all VDV, security, fire/life safety, fiber optics, home/building automation systems, and integrated building systems applications)

Engineering/Architecture/Consulting

Systems Integration/Consulting

Wholesaler/Distributor

Other (please describe)

3.	Primary job title or function: (Check ONE only)

Executive Management: Owner, Partner, President, VP, Gen. Manager, etc.

Management: Project Manager, Superintendent, Supervisor, Foreman, etc.

Electrician (field), Journeyman, Technician, Installer, Service Person, etc.

Staff Engineer, Designer, Electrical Engineer

Estimator

Purchasing Agent, Buyers

Other (please specify)

4.	Total number of people who work for your company (all locations combined).

5.	What Low Voltage Certifications/Accreditation do you currently hold? (Check all that apply)

RCCD

LAN Specialist

CISCO

Microsoft

Other

6.	CHECK ALL Construction Types you or your company have performed.

7.	CHECK ALL of the Building Components you or your Company have installed.

Security (includes CCTV, Access/Motion/Intrusion Systems)

Fire Life Safety Systems

Total Building Automation Systems (includes HVAC)

Fiber Optics

Communication Systems (Voice/Video/Data)

Premises Wiring

Maintenance/Service/Repair

Power Quality Systems (Standy. Co-gen, etc.)

None of the Above

8.	What is your company's estimated total annual sales?

9.	Email Policy: On behalf of our advertisers and marketing partners we occasionally send bona-fide Electrical Contracting product and service industry opportunities to our email audience. This email service is strictly administered by ELECTRICAL CONTRACTOR and NOT by our marketing partners.

To opt out of receiving such occasional market related information, please check here.

10.	In lieu of a signature, we require a unique identifier used only for subscription verification purposes. What is the day of your birth?

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