I would like permission to post data from BMC Weekly StatLine on my website. I agree to prominently site Beverage Marketing as the source of the data and to provide a link back to the Beverage Marketing Website www.beveragemarketing.com. I also agree that this data will not be re-sold.

Name:

Title:

Company:

Address:

City:

State:

Zip:

Country:

Phone: (important)

E-mail:

Fax:

My organization is a:

Beverage Company

Beverage Industry Supplier

Trade Association

Online or Print Media Publication

Other - Please specify

The Information will be posted on the following website.

The Information will be posted in the following print publication

Beverage Marketing Corporation
850 Third Avenue
New York, NY 10022
Tel: 800-275-4630 | Outside U.S.: 212-688-7640
Fax: 212-826-1255