Please fill out the form completely and thoughtfully.  If you do you will be a long way through the planning process and not even know it.  Visualize as you go.

First Name:   Last Name: 

Business Name:  if you don't have one yet, just type "None".

Business Address 1:  
                        Type?:  Pick One Business Home
Please No PO Boxes.  UPS will only deliver your samples and treat to a street address.

Business Address 2:

City:   State:
 Zip:

Telephone: 

E-Mail:

Web Address:
Open?      Planned ?

Type of Store Planned: Pick One Cafe with Food Coffee House with entertainment, no food Coffee House with entertainment and food Coffee House Bagel Store Deli Cart High Volume Cart Pretty High Volume Other

When?: Pick One This Week Next Month Six Months One Year When I get $   

Size in Square Feet: Pick One Under 1000 ft 1 to 2 Thousand ft. 2 to 4 Thousand ft. Over 4000 ft. Cart

You are doing great and almost done.  Keep thinking.

A check in the following boxes means yes.

Will you. . .? 

Brew Sell Beans
Sell Prepackaged Make Baskets

The Following links will bring you to lists, so you can decide with more information.

Will you carry Origins? How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None  

Carry Blends?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None  

Carry Regular Decafs?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None  

Carry Swiss Water Processed Decaf? How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None

Carry  Flavored?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None  

Carry Flavored Decafs?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None

Carry Natural Flavors?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None

 Carry Organics?  How Many:  Pick One 30+ 20-29 10-19 5-9 1-4 None  

Carry Fair Trade?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None

Carry Bird Friendly®? How Many:  Pick One 30+ 20-29 10-19 5-9 1-4 None

Carry Sustainable Harvest?  How Many: Pick One 30+ 20-29 10-19 5-9 1-4 None

Total Coffees Carried: Pick One 100 - 199 75 - 99 50 - 74 25 - 49 25 Brew Only

One Grinder?      Two Grinders ?
One Brewer?       Two Brewers?

Shuttle for 1000 cups   Plumbed for 500 cups/day

Espresso Machine? Pick One 3 Group 2 Group 1 Group
Espresso Grinder?  Pick One 2 1 0

Roasting?  Pick One Yes, but a small 1 or 2 pounder Yes, a 15-ound Batch Roaster Yes, a 25-pound Batch Roaster No, I will not be roasting
I want a Chain of:  Pick One 10+ 5-9 3-5 1-3

Breakfast?:  Pick One Bagels, Muffins, Toast Grill and Bake Sit-down table, service grill and bake Take out grill and bake Light take out only  

Lunch ?:  Pick One Sandwiches Salads Soup Grill Soup and Salad Soup, Salad, Sandwich All All, but take out only

Dinner?: Pick One Informal Semi-formal, no table cloth White tablecloth and candles

Entertainment?: Pick One Poets Folk Music Light Rock Heavy and Loud Poets, Folk and Light Rock All None   Sound System

More Drink Stuff

Chai Tea   Tea    Cocoa   Granita  
Candy It sold well at a library on Saturday afternoon!

Iced Tea  

Cash Register      Computer         

Credit Card Machine   Yes No   

You made it.  Thank you.  Your Samples and Treats will be on their way.  Come back as frequently as you wish.