Press Input Form

This form allows you to provide users of the Info-Xone with information about your publication. The InfoXone deals with a large number of enquiries every day, so it is in your interest to be accurate and to keep the information up-to-date.

Please provide the following contact information:

Name of Publication:
Publisher:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal code:
Country:
Work Phone:
FAX:
E-mail:
URL:

Please indicate subject areas covered by your publication (tick as many as are applicable):

International News	National News	Local News
Agriculture	Arts	Broadcasting
Building/Construction	Business/Services	Charity
Clothing	Education	Electronics
Engineering	Financial Services	Food and Drink
Government	Health/Pharmaceutical	IT
Leisure/Travel	Manufacturing	Media
Professional Services	Property	Retail
Sport	Telecommunications	Transport
Utilities

Please indicate your primary target audience (tick as many as are applicable):

General Public	Women	Men
Social Classes A, B, C1	Social Classes C2, D & E
Age Group 15-24	Age Group 25-34	Age Group 35-44
Age Group 45-54	Age Group 55-64	Age Group 65 & over

What is the circulation of your publication?/

What is the readership of your publication?/

List the names and job titles of the editor and any other senior journalists:/

Any other information you would like included:/

Any comments to help us:

For quality control and checking purposes, please give:

Name of respondent:/

Job Title of Respondent:/

Panarc International reserves the right to check, edit or reject any submission.

Last revised: November 15th, 1999

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