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Establishment:
(Name of Business)
Name:
Title:
Street Address: (No P.O. Box, Please)
City:
State:
Zip Code:
Phone: --
Fax: --
Email:
Primary Distributor:
Average # of meal served:
(per day)

Menu Type: (check all that apply)
Wings
BBQ
Breakfast/Donuts
American,mixed
Other
Steak
Sandwiches/Deli
Asian
Pizza
Mexican
Italian
Seafood
Non-Commer

Type of Operation:
Full Serv. Midscale/Family
Hotel/Motel
Full Service Casual/Theme
Retail Hosts
Cafeteria & Buffet
Caterers
Hospitals & Nurs. Homes
Business & Industry
Travel & Leisure
Quick Service
K-12
Bar & Tavern
College & Univ.

Ownership:
Chain
Contract Management
Independent

Comments:

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