Company or Name: (How would you like to be listed?)
*Leave this box empty if this is a personal listing.
Primary Contact Name:
First:       Last:
Title:
Street Address:
City: State:
Country: Postal code:
Main Phone: Main Fax:
Phone #2:
Pager:
Web Site URL:
E-Mail:
In which category would you like to be listed (up to three):
   Service 1:
   Service 2:
   Service 3:
In which region would you like to be listed (up to three):
   Region 1:
   Region 2:
   Region 3:
Union Affiliations: (If Applicable)
In which of the following fields are you active?
Features   Television   Commercials   Industrials
Music Videos   Documentaries   Interactive
The following information is requested for market research only:
How long have you worked in the entertainment industry?
Years 		How long have you worked in your current position?
Years
Your Gender:

Male   Female 		Your Age:
How are you connected to this site?
 How fast is your connection?
How did you first find MAX?
 What do you like/dislike about MAX?
What other industry sites do you like?
 List two references w/phone number:

To have one of our representatives contact you. . .
Check here if you would like to learn more about advertising on the site
Check here to place your resumé on the site