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YOUR DETAILS
Title
Initials
Surname
Date of Birth
Company Name
Postcode
Telephone Number
Fax Number
e-mail address


JOB TITLE
What is your seniority?	MD/Owner C.E.O
What is your seniority?	Director (please specify)
	Manager (please specify)
	Other (please specify)
If you are not the MD or C.E.O please fill in their names	C.E.O MD

COMPANY ACTIVITY
Is your company a:
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INDUSTRY TYPE
What is your company's main product/service? (please specify)


PROFESSIONAL BODIES
Are you a member of any of the following?	IMC
Are you a member of any of the following?	ICA (IND, CON, ASS)
	INST, PROJ, MGT
	CIMA
	ACCA
	CIPFA
	ILDM
	CIM
	IOD
	ICAEW
	AMBA (MBA)
	SPM
	IPM
	Other (please specify)

SIZE OF ORGANIZATION
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RESPONSIBILITES
What is your primary job function?	Other (please specify)


OTHER RESPONSIBILITES
Which of the following do you have a decision making influence on?	Other (please specify)


DISTRIBUTION
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SITES
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TURNOVER
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