Customer Information
Name:
Company Name:
Type of Company:
Phone:
Email:
Census Request Detail:
Markets - Cities, Counties, MSAs, States, Custom Region, and/or Other (please specify):
Time Frame - Current or Most Recent, and/or History (please include year):
Station Types - All Stations and Brands in Market, Specific Stations or Brands in Market,
C-Stores, Car Washes, Gas Only, Service Bays, Truck Stops, Card Locks, and/or Other
(please specify):
Level of Detail - Market Share, Throughput, Class-of-Trade, Fueling Positions, Pump Types,
Ancillary Sales/Profit Centers, Co-Branded Fast Food, Facility Features and Services,
Address/Phone, Geocoding, or Full Market Detail (please specify):
Preferred File Format - Excel, FoxPro, CSV, Tab-Delimeted Text, or other (please specify):
Delivery - Email, FTP, Disk, CD, Hard Copy, Mail, FedEx, or Other (please specify):
Others/Comments:
