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QUALIFICATION FORM

Incomplete forms will not be processed. A complimentary subscription to Rental Product News 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 Rental Product News magazine FREE of charge.

Yes!

No

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

2.	What category best describes the primary business activity at your firm? (Check only one.)

General Rental Center (renting equipment, machinary, tools, other items)

Distribution / Dealer (engaged in selling and renting equipment and tools)

Retail Firm with Rental Department

Manufacturers' Representative

Other (please specify)

3.	Please fill in the category that best describes your job title. (Check only one.)

Owner / Partner / President / General Manager / Other Corporate Officer

Manager (Sales Manager, Branch or other Manager)

Supervisor or Department Head (Dept., Mgr., Foreman, Chief / Head Mechanic)

Other (please specify)

4.	What type of rental service is provided at this location?

Contractor / Industrial Equipment Only

General / Homeowner Equipment Only

BOTH Contractor / Industrial Equipment & General / Homeowner Equipment

5.	What is your annual sales volume?

6.	Please indicate what types of products you rent: (Check all that apply.)

General construction equipment

Lifting equipment

Earthmoving equipment

Attachments (for skidsteers, loaders & excavators)

Compaction equipment

Concrete working equipment

Hand tools

Lawn & grounds maintenance equipment

7.	What is your firm's replacement value of equipment and trucks owned and/or leased for your company's use?

8.	Do you wish to receive Product or Service information from our Industry partners via e-mail:

Yes

No

9.	In order to verify your request for this publication, without the availability of a signature, our audit bureau requires that we ask a personal identifying question. This information is used solely for the purpose of auditing your request. What day of the month were you born?

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