First Name: *

Last Name: *

E-mail: *

Business Phone: *

City: *

State/Province: * --Please Select-- Alaska Alabama Arkansas Arizona California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming American Samoa Alberta British Columbia Guam Manitoba Marianas Marshall Islands Micronesia Military Americas Military Europe/ME/Canada Military Pacific New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Palau Prince Edward Island Quebec Saskatchewan Yukon Territory --------------- Not Applicable

Country: * --Please Select--United StatesCanadaUnited KingdomSweden--------------AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBrit/Indian Ocean Terr.Brunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Dem. Republic OfCook IslandsCosta RicaCôte D'IvoreCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern Terr.GabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard/McDonald Isls.HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea (North)Korea (South)KuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarN. Mariana Isls.NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSamoaSan MarinoSao Tome/PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSt. Vincent and GrenadinesSudanSurinameSvalbard/Jan Mayen Isls.SwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks/Caicos Isls.TuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUS Minor Outlying Is.UruguayUzbekistanVanuatuVatican CityVenezuelaViet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis/Futuna Isls.Western SaharaYemenZambiaZimbabwe

Company/Organization: *

Job Role: * --Please Select--Account ExecutiveAdministratorAssistant/CoordinatorAssociateChairman/CEO/COO/PresidentConsultantDeveloperDirector/HeadFreelancer/WriterInternJob ApplicantJournalistManagerOfficerOwner/FounderPrincipal/PartnerProfessor/DeanPublicist/PublisherReporterSecretarySpecialistStudentVice President

Job Function/Department: * --Please Select--Accounting and FinanceBusiness PlanningCommunity DevelopmentFundraisingHuman ResourcesInformation TechnologyInvestor RelationsMarketingMembership DevelopmentPublic Relations/Corporate CommunicationsSalesOther

How Large is Your Marketing/PR Dept? * --Please Select--There are a whole bunch of usThere are a few of usIt's just meDon't really have a PR department

Number of employees: * --Please Select--Small BusinessLess than 1000 employeesMore than 1000 employees

Company Revenue: * --Please Select--Small BusinessLess than $200 millionMore than $200 million

How are you managing your Marketing/PR campaign activities?* --Please Select--I'm using one or more of your friendly competitors.I'm working with an agency.I'm doing it in-house and/or using free services.I'm not doing anything.I'm a Cision Customer.

Are you using a social media monitoring tool? *

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