Research Panel Membership Request Form

Best Practices Research Panel Membership Request

Complete the following form to request membership in the research panel.

Name:
Company Address:	Please include city, province or state, postal & zip codes as appropriate
Day Phone:
Company Email:
Company:
Your Area/Department	Example, finance, marketing, manufacturing etc.
Your Job Title (select the best fit)	Senior Management Director Manager Staff Internal Consultant Other

Industry Select the most appropriate

Retail
Manufacturing Only
Distribution (including transportation) Only
Manufacturing & Distribution

Select the number of employees at your individual unit (not worldwide employment unless you are corporate staff/management)

1-100 employees	100-1,000 employees	greater then 1,000
Not sure/not available

Please review the terms & conditions of membership