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What is the best description of your business?


FREE MAGAZINE REGISTRATION


To apply for your FREE regular copy of IER - INDEPENDENT ELECTICAL RETAILER, please complete your details below and answer ALL the questions.


Then either fax this form to (0845) 604 2327 or post to: Capsule Group, PO Box 228, Lewes BN7 9JA


NAME: _______________________________________________ JOB TITLE: ___________________________________________ COMPANY NAME: _____________________________________ POSTAL ADDRESS: ____________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ POSTCODE: __________________________________________ TELEPHONE: _________________________________________ EMAIL: _______________________________________________ MOBILE: _____________________________________________


How would you like to receive your copy of the magazine: Digital


Print What is your primary job function?


2000 Other 2055 Buyer/Purchasing/Specifier 2110 Corporate Management 2195 Finance 2455 Proprietor/Owner 2495 Sales & Marketing 2510 Service 2515 Shop Manager


Both


1000 Other 1165 Electrical Goods Distributor 1270 Independent Electrical Retailer 1380 Manufacturer/Importer/Supplier 1415 Multiple Retailer 1535 Service & Repair of Electrical Goods


How many employees are there in your organisation?


0100 001 [Sole Trader] 0110 002 to 004 Employees 0120 005 to 009 Employees 0130 010 to 019 Employees 0140 020 to 049 Employees 0150 050 to 099 Employees 0160 100 to 499 Employees 0170 500+ Employees 0190 Unknown


Please tick all products/services you sell in your shop/store


5034 Audio/Soundbars/DAB Radio 5037 Audio/Video Accessories, Spares & Consumables 5103 Built-in Appliances 5157 Computers/Multi-Media 5163 Cookers & Hobs 5196 Digital Cameras 5206 Dishwashers 5220 DVD/Blu-Ray Home Cinema Systems 5226 Electrical Heating Appliances 5274 Floorcare Appliances 5295 Freestanding Appliances


Please tick all products/services you sell in your shop/store


5319 Hair/Personal Care Appliances 5401 Laundry Applications 5406 LCD/LED/3D Televisions 5542 Refrigeration Appliances 5544 Repairs/Servicing 5571 Satellite Equipment 5631 Small Kitchen Appliances 5685 Tablets & eBooks 5691 Telephones/Mobile Phones 5739 TV/DVD/Blu Ray Hire


The Publisher may decline to supply free magazines or services to those who opt out of these services (tick all that apply)


 Datateam Business Media Limited may occasionally pass your details to other reputable companies whose products and services may be of interest. Tick this box if you do not want to receive such offers.


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 Datateam Business Media Limited companies may send you this information by email. Tick this box if you are not prepared to receive notices from us by email.


Signed _____________________ Date: _________


I confirm that I am applying for FREE copies of IER - INDEPENDENT ELECTRICAL RETAILER.


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