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RS&S

Background Survey 

Please fill out below completely - items in black are required.
If you have any questions please contact Regina Beischer at 732-886-5935.

First Name:

Last Name:

Title:

Company:

Website:

Address:

City:

State/Providence:

Zip Code:

Country:

Email:

Telephone:

Fax:

Category of Retailer:

     

If other please specify:

  

 

Type of Merchandise:
(Select all that apply - Ctrl +) 

     

If other please specify:

 

Number of Stores:

    

Geographic Location:
(Select all that apply - Ctrl +)

   

 US Regions:
(Ex: All States, North East etc.)

  

 

 
     
© Association for Merchandise Planning and Allocation (AMPA)