FILL OUT INFORMATION BELOW




Name:

Email Address:

City

State

Phone #

Have you found a location for your business ? YES

NO

Is your location within the City limits ? YES

NO

Sq Ft of the location ? 800-1200sq ft

1200-1600sq ft

1600-2200sq ft

2200-3000sq ft

3000sq ft+

Number of parking spots available for your customers ?

Please check the following that apply. Fees per business

Fees per terminals

Special use permits

Moratorium in place

How many other sweepstakes cafes are currently within a 10 mile radius of your desired location ? 1

2

3

4

5

6+

Have you ever run this type of business before ? YES

NO

Do you wish to fill out a credit application for purchasing Equipment ? YES

NO

Question # 1

Question # 2

Question # 3