Store/Company Name:
Address:
City:
State:
Zip Code:
Country:
Phone:
Web Site Address:
Contact Name:
Position:
Email Address:
Type of retailer:
Boutique
Department Store
Specialty Chain
Discounter
Internet
Number of store/retail locations:
Sizes sold in stores:
(choose all that apply)
Plus 14-24
Plus 26 and up
Misses
Juniors
Other:
Target age group
(choose all that apply):
Teens
Twenties
Thirties
Forties
Fifties and up
Average retail price range
of a Long Sleeve Blouse
in your store (USD):
less than $20
$20-$39
$40-$59
$60-$79
$80-$99
$100-$119
$120 and up
Labels/Brands that you carry
(must fill in at least one):
Number of years in business:
How did you hear about us?:
Customer
Other Retailer
Internet
Magazine
TV
Other:
Thank You!
We will contact you soon.
