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 (Branded Wholesale) & Co-op Independent - Strategic Symbol - Strategic

Form Completed By: Full Name *

Form Completed By: Email Address *

RRM *

Andrew Hodges Andrew Rutter Christine Heaton Mark Sheppard Michael Love Nigel Maxwell Specialist Recruitment Other

RDM KAM *

Andrew Hodges Andrew Wilford Anthony Newman Darren Bacon Davina Clifton Fiona Shearer Glen Tuffrey Glyn Cooper Holly Perry James Townsend Josh Williams Krishna Hingorani Leanne Millar Lee Westwood Luke Arnold Mark Winfield Neil Potter Nigel Maxwell Phil Howell Phil Knox Richard Bishop Richard Shorney Russell Armstrong Ritesh Malhotra Sarah Wileman Steve Emberson Tom Clarke Tony Pickford Tracey Harrison Specialist Recruitment

BDM *

Andrew McKenzie Bruce McCullen Martin Hawthorne Martin Ojo Kerry Moore Laura Swales N/A

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 Local Independent Nisa 2.0 Independent (PTS) & Co-op

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

Contract Terms *

Contract in place Approved - Signature Required In Progress Establishing Requirements

Nisa 2.0 Eligibility *

N/A Not Discussed Discussed – In Principle Discussed – Details Shared Agreed – In Principle Agreed – Ready to take to Forum Approved in Forum

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 *

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

Competitor Brands SKU Level *

No Competitor SKU's Currently being sold through Full exit strategy required

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.

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

CONFIRMATION Important: Total image attachments must not exceed 20MB. If your submission exceeds this limit, it may fail and you will not receive a confirmation email.