Food Service

Title Dr. Mr. Mrs. Ms.    Name

Title

Company

Length of time in business years months

Dun's number or Federal Tax ID

Address

Address

City Choose a State Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory

  Zip Code   -         Country

Phone   -   Ext.          Fax   -  

Best time to follow up

E-mail   (e.g. yummy@bogdonschocolates.com)

Your website address

Would you like to receive our special email offers?   

Yes No

How did you hear about Bogdon's?

What type of Food Service establishment do you operate?

Choose one Restaurant Hotel Catering

Who makes purchasing decisions within your company and what is their title?

I do. Someone else: (please enter as Name, Title)

Do you currently use an after dinner candy?

No Yes (if Yes, please specify which one)

How many seats do you have in your restaurant? Choose a number 1-20 20-50 50-100 100-300 300+

Do you buy direct or from a distributor?

If you checked the latter, would you like a list of our distributors?   

Yes No

Would you be interested in private labeling opportunities?   

Yes No        What does this mean?

If you have any further comments or questions, please note them here:

Thank you for your interest in Bogdon's Chocolates.

We appreciate your time and your business.

We will contact you with pricing information upon processing of this form.

I'm done.        I would like to start over.

If you would rather print this and fax it to us, our fax number is 1-913-262-6885.