Questionnaire for Producers, Growers, Stores, Tours, Museums

CONTACT INFORMATION

(items marked with an * are compulsory fields)

STATE: *

STATE TOURISM REGION

NAME OF BUSINESS: *

TYPE OF BUSINESS: *

NAME(S) OF OWNER/OPERATOR: *

ADDRESS: *

TOWN: *

POSTCODE: *

TELEPHONE

FAX

EMAIL ADDRESS

WEBSITE

ABOUT YOUR BUSINESS

What is the specialty of the business?

How long have you been doing this?

Why did you start?

Tell us about your product:

These products are

Only sold locally at:

Sold locally and throughout the state--

Sold nationally--

Sold nationally and exported---

What are the brand names/varieties that you produce?

Where are they sold?

Name of outlets, restaurants etc

Is this product unique to your business?

If so, whose idea was it?

Do you manufacture something

where do you get your raw materials from?

We are always interested in the story behind each business. If appropriate, tell us how you came to open this business, your background, other experience in the food industry etc.

Is your business open to the public?

Yes No

Operating Hours

Directions for finding your business

Images

I give you permission to use images from my existing web site

I will email you images separately EMAIL HERE

TERMS & CONDITIONS:

I wish to subscribe to a (please select): *

In submitting this form I understand that I will be invoiced for an establishment fee of $165 ($150 plus $15 GST) for a Gold Premier Listing OR $137.50 ($125 PLUS $12.50 GST) for a Silver Plus Listing OR $82.50 ($75 plus $7.50 GST) for a Silver Premier Listing. * _________ Yes