Government Video Free Subscription

	*Government Video* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Government Video*, 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 Government Video?*

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First Name:
Last Name:
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	(Ex: Director, Vice President, Project Manager, etc.)
Company Name:
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	(Note: If your country is not listed above, subscriptions are not currently available at your location.)
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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.	*Would you like to receive your Government Video* subscription in a digital format instead of print if it becomes available?**

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3.	You will receive subscription notifications via email. Do you wish to receive other email and other promotions from NewBay Media LLC?

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4.	Would you like to receive email and/or promotions from trusted NewBay Media LLC marketing partners?

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5.	Reader feedback is important to NewBay Media LLC. May a member of NewBay Media LLC's Editorial Research team contact you via email?

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6.	*Would you like to receive exclusive articles and white papers from Government Video's editors and partners in a digital, interactive format if it becomes available?*

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7.	Organization: (select only one)

Dept of Defense (Military & Civilian personnel/Other defense funded entities)

Federal Government (FBI/CIA/Other Federally funded law enforcement entities, Research Executive/Judicial/Legislative Branches, Department of Labor, Transportation, IRS, Social Security, and Other federal funded entities)

State/County/City Governments (Law Enforcement Agencies, Fire Departments, Judiciary branches, and Other tax funded entities)

Prime Contractors/Integrators/Dealers/VAR's/Systems Designers & Installers

Manufacturer/Manufacturers Rep

Independent Teleproduction/Post Production/Duplication/Multimedia/Animation & Graphics House

Consulting Firms/Services

Other (please specify)

8.	Job Description: (select only one)

Management/Command Procurement/Purchasing

Production/Post Production/Editor, Camera Person, Lighting, Audio and Other Creative Personnel Presentation (Audio/Video/Audio Visual/Graphics) Training, Education, Multimedia

Engineering/Technical Support Other (please specify)

9.	Major Application Area: (select all that apply)

Video Production Video Conferencing/Distance Learning

Training and Presentation Medical/Scientific/Imaging/Research

Broadcast/Cable/Satellite Other (please specify)

CCTV/Surveillance/Security

Computer Graphics/Multimedia

10.

Do you work in an in-house A/V production or video conferencing facility?

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11.

Do you buy, specify or recommend products or services used in A/V, visual communications or imaging?

Yes No

12.

What is the annual equipment and software budget for A/V and related products for your specific facility? (select only one)

$500,000 or more $25,000 to $99,000

$250,000 to $499,999 $10,000 to $24,000

$100,000 to $249,999 $9,999 or less

13.

Which of the following product categories will you be evaluating for purchase within the next 12 months? (select all that apply)

Cameras & Accessories (All Image Acquisition Related Products)

Post Production (All Image Manipulation Equipment and Software)

Presentation (All Output-related Devices, i.e. Monitors, Projectors)

Transmission (CD-ROM, Duplication, Cable, Satellite, Broadcast, Phone or Data Links)

Microphones (All Audio Input Devices)

Recorders/Mixers/Workstations (All Manipulation and Storage Products)

Speakers/Monitors/Headsets (All Output Devices)

PC

Macintosh

SGI

None Of The Above

14.

What method do you use to purchase A/V related products and services? (select all that apply)

Open Market - Dealer or Reseller GSA Schedule - Dealer or Reseller

GSA Schedule - Manufacture Direct None of the above

Open Market - Manufacture Direct

15.

In lieu of a signature, Audit Bureau regulations require that we ask a validation question as proof of your request to subscribe. What is the name of the high school you attended?

Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com?

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What is your budget for this project? (select only one)

$1 - $999 $2,500 - $4,999

$1,000 - $2,499 $5,000+

Do you have a Website? If yes, please provide the URL.

* Note that a valid email address is required to fulfill your request. Please verify that the email and mailing address you provided are accurate before hitting the submit button.

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