Organic Products Retailer : Subscribe

Free Subscription Form

Complete all required information below, print this form
and fax to the number at the bottom of this page.

1. I wish to recieve/continue to recieve Organic Products Retailer FREE of charge.

Yes! NO

2. What is your job title? (check only one)

A. Owner/President

B. Vice President/General Manager

C. Division/Store Manager

D. Buyer/Purchaser

X. Other:

3. What is your primary business:

A. Natural/Organic/Health Food Store	E. Wholesaler/Distributor
B. Supermarket	F. Manufacturer/Supplier
C. Pharmacy/Drug Store	G. Grower/Farmer
D. Natural Product Broker	X. Other:

Please fill in the following information:

PLEASE PRINT THIS FORM WHEN COMPLETED
AND FAX TO (847) 466-0527.