Business Support Request Form

ALERT

Prospect?

Yes No

Trade Commencing Date * Date picker

Account Number *

Business Name *

Contact Name *

Business Address *

Postcode *

Email *

Phone Number *

Store Type *

Symbol Fascia - Traditional Symbol Fascia - Key Account Independent - Traditional Independent - Key Account Specialist

Form Completed By: Full Name *

Form Completed By: Email Address *

RRM *

Mark Winfield Nigel Maxwell Michael Love Specialist

RDM *

AJ Dang Amy Hardy Andrew Hodges Andrew Wilford Anthony Newman Chetna patel Darren Bacon Fiona Shearer Glyn Cooper James Townsend Lee Westwood Mark Winfield Michael Love Neil Potter Nigel Maxwell Phil Howell Phil Knox Richard Bishop Richard Shorney Russell Armstrong Steve Emberson Tom Clarke Tony Pickford Tracey Harrison Specialist

SDM Required?

SDM Required?

Current Fascia *

Independent Independent IFG Loco Nisa Express (Grey) Nisa Local (White) Nisa Local (Grey) Nisa Extra (White) Nisa Extra (Grey) Co-op Disposal Competitor Fascia (Please advise in notes)) Dual Express Dual Local (Grey) Dual Local (White) Dual Extra (Grey) Dual Extra (White) None

Proposed Fascia *

Evolution Express Evolution Local Evolution Extra Independent Independent IFG Dual Express Dual Local Dual Extra

Approx. Store Size *

Express <1000 Sq. Ft X Small 1000-1499 Sq. Ft Small 1500-2499 Sq. Ft Medium 2500-3499 Sq. Ft Large 3500-6499 Sq. Ft X Large >6500 Sq. Ft

Store Demographic *

Value Standard Affluent

Store Format *

Highstreet Neighbourhood Forecourt

Development Budget *

<£10k £10k-£30k £30k-£60k £60k-£100k >£100k

Terms *

7 Day Credit 14 Day Credit Proforma

If prospect, what stage? *

Accounts Submitted Application Submitted Account Pending

Track & Trace & BWS Licence Complete?

Track & Trace & BWS Licence Complete?

Other Incentives Agreed

Reason for Visit *

Subscription Relay Support (CAD only) Conversion (Existing Customer) New Store (Existing Customer)) Empty Unit (Existing Customer) Minor Refit (Existing Customer)) Major Refit (Existing Customer) Empty Unit (New Customer) Trading Store (New Customer)

Current Weekly Turnover *

Expected Weekly Turnover *

Proposed Store Launch Date * Date picker

is there a CAD Plan available? *

Yes
No
Unknown

Number of Chill Bays *

Bread & Cake Bays *

Ambient Produce Bays *

Number of Frozen Doors *

Impulse Ice Cream

Impulse Ice Cream

EPoS Required?

EPoS Required?

Epos Incentive Deal Available *

Yes
No

Current EPOS System *

Amazon Arciris Corby & Fellas Cost Cutter EPOS_IN_USE Epositive Evolution Fujitsu Indigo ITS Martin McColl MPOS MSP Nikul Ocean Pacific Mobile app nisa OCS_MBL Orbis Point Four PROTEUS proudfoot RCS Reposs Re-scan Retail data partnership Retail solutions Sirius STD Torex VME Retail YP Electronics Unknown Other No EPOS system

Number of Till Points *

1 2 3 4 5 6 7 8 9 10+ 1+SCO 2+SCO 3+SCO 4+SCO 5+SCO 6+SCO 7+SCO 8+SCO 9+SCO 10+SCO

Notes * To include brief outline of the store, overall retailing and hygiene standards, what competition is nearby and any other relevant information required. If existing partner, please advise whether the store has achieved Optimal or Credible level. What are the current number of Co-op skus?

Add Pictures * Please add at least 2 pictures of the store, one external and one internal. Select multiple files by holding Ctrl key and clicking the files you would like to upload.

Choose file