FenderBender FREE SUBSCRIPTION/RENEWAL FORM

A complimentary subscription will be sent to all qualified applicants residing in the U.S.A. Fields marked in red and the six questions below are required to process this request.

Is this a NEW Subscription or a RENEWAL? NEW Subscription RENEWAL Subscription

Priority Code

First Name

Last Name

Title

Company

Exactly as it appears on your mailing label:
If different from your mailing label:
* If no company appears on your mailing label, then enter NONE in the first box.

Address

City

State

Zip

Phone

Fax

E-mail Address

PLEASE ANSWER THE FOLLOWING QUESTIONS.

1. I wish to receive (continue to receive) a FREE subscription to FenderBender.
Yes No

2. Which best describes your job title?
Owner/Partner/President/Vice President and Other Company Officials
Manager/Shop Manager/General Manager/Director/Administrator/Superintendent
Shop Foreman/Shop Supervisor
Other (please specify)

3. Which best describes the primary business at this location?
Independent/Franchise Vehicle Body Repair Shop
New and/or Used Vehicle Dealer with Body Repair Shop
Wholesaler/Warehouse Distributor Specializing in Paint, Body Repair or Equipment Lines
Other (please specify)

4. What is your total yearly sales volume?
Less than $250,000
$250,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000 - $2,499,999
$2,500,000 and above

5. How many employees (including yourself) work at this location?
1 - 2
3 - 4
5 - 6
7 - 8
9 - 10
11 or more

6. To permit future verification of your request, in which city/town were you born?

Are there other employees at your location who should receive FenderBender...free? (Job title is required for all referral names.)

First Name
Last Name
Title
E-mail
First Name
Last Name
Title
E-mail
First Name
Last Name
Title
E-mail

Publisher reserves the right to serve only those who meet publication qualifications.

FenderBender
420 Summit Ave
St Paul, MN 55102
Email: subscriptions@fenderbender.com
Fax: 651-224-6212