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| 1. | Do you wish to receive a FREE subscription to NICHE Magazine? |
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| | What is the approximate number of employees in your company? (select only one) |
Yes, please auto-fill my contact information for other publication qualification forms.
| 2. | Job Title: (select only one) |
| 3. | Which category best describes your business type? (select only one) |
| 4. | If you are a RETAILER, please specify type: (select only one) |
| 5. | Please indicate PRODUCTS sold: (select all that apply) |
| 6. | Please indicate your business location: (select only one) |
| 7. | Please indicate SHOWS you attend: (select all that apply) |
| 8. | What Made in the USA lines do you carry? (please specify) |
| 9. | What top gift lines do you carry? (please specify) |
| 10. | Store theme: (select all that apply) |
| 11. | What % of your customers are women? (please specify) |
| 12. | What is the average net worth of your customers? (select only one) |
| Less than $99,000 |
$500,000 - $749,000 |
| $100,000 - $249,000 |
$750,000 - $999,000 |
| $250,000 - $499,000 |
$1,000,000+ |
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| | What is your projected annual online revenue? (select only one) |
| | Net Worth: (select only one) |
| | Capital To Invest: (select only one) |
| | When would you like to start? (select only one) |
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