Title
DR
MISS
MR
MRS
MS
First Name *
Last Name *
Email Address *
Date of Birth *
Address *
City *
State *
Postcode *
Country *
-- Select Country --
AFGHANISTAN
ALAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CâTE D'IVOIRE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA AND MONTENEGRO
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA
VIETNAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Mobile Phone Number *
Gender *
Male
Female
Occupation *
Choose only 1 that best describes you *
Homebrewer
Beer Enthusiast/Lover
New to beer & interested
Brewing trade
Retail/wholesale liquor/hospitality trade
Other
None of the above
Hobby's / Interests *
Beer & Brewer now offers beer tours *
Weekends away in Australia
Weekends away in NZ
Guided tours
Organised trip - without a guide or tour group
Tours to Europe
Tours to UK
Tours to USA
Tours to Canada
Tours to Asia
Other
What price bracket are you interested in spending, incl. all travel and accommodation for overseas beer tours *
Less than $5000
$5000-$8000
$8000-$10
000
More than $10
000
How many days would you like to go on a weekend away trip *
How many days would you like to go on a beer tour *
-- Please select --
7 or less
7-10
10-14
14-21
21+
What do you drink/taste other than beer (can be alcoholic or alcohol free)? *
Where do you buy most beer (commercial, premium, craft, imported, etc.) Bottle Shop – National Chain. Please provide the name
Bottle Shop – Independent Please provide the name
Pub/bar/restaurant/café. Please advise the name
Online. Please advise the name
Mail order. Please advise the name
Where do you mostly drink/taste beer *
At home
At a friends/relatives place
At the pub/bar/restaurant/café
What is your favourite section or article in the magazine? *
Is there anything we are not writing about that interests you? *
Is there any content that you don’t like in the magazine? *
What origin of beer do you drink/taste most *
Craft
Imported – fully imported
Imported – brewed under license
Local – commercial
Do you read the printed version of Beer & Brewer magazine? *
Yes No
Have you bought a Beer & Brewer Pack before? (mail order beer in the magazine) *
Yes No
If No – What is the reason for not buying each pack? Not aware they exist. If so, using what communication can we promote the packs to you?
If price – what price are you willing to pay up to, given it’s a combination of local and imported beers?
If Selection, tell us what kind of beers you are looking for in the pack
If Yes – Was it for
Gift Yourself
What price would you be willing to pay for a beer pack mailed to your door? *
How many bottles of beer would like delivered? *
How often would you like to receive a pack of beer mailed to your door? *
Weekly
Fortnightly
Monthly
Every 2 months
Quarterly
Every 6 months
Annually
How many different brands/types of beer would you like delivered? *
Would you prefer to *
Join a Beer & Brewer Club and automatically be charged for the beer pack each quarter/occasion?
Decide on whether to buy a pack as they are published (current method)?
Tell us in 50 words or less why you would/wouldn’t like to buy beer through the magazine *
Enter Word Verification *
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