SuperCoffee.org

SUPERCOFFEE
1272 Mysty Woods
Victoria, BC V8Y 3G6

Phone: 250-595-5974
Fax: 250-595-5984
Toll Free: 1-800-677-0990

Thank you for choosing to contact us. Please answer the following set of questions when contacting us so that we may better assist you.

* - Denotes a required field.

* Your Name:
* Company Name:
* Phone Number:
Alternate Phone Number:
* Email Address:
* What type of office coffee service are you interested in?	Not sure - please advise
	Single pot coffee packages (also known as frac packs)
	Single cup coffee machines
	Other (please specify):

* Approximately how many people, per day, visit the location where you are interested in office coffee service?	1-20
	21-50
	51-100
	100-500
	500+
* Do you currently have a coffee service provider for your office?	No
	Yes, Please indicate which (if known):

* For what type of location do you need office coffee service?	Industrial/manufacturing facility (plant, warehouse, etc.)
	Office location
	Educational institution (school/college/university)
	Retail store
	Medical facility (hospital/medical clinic/nursing home)
	Lodging (hotel/motel)
	Restaurant/bar/night club
	Other (please specify):

* What is your buying timeframe for this office coffee service?	ASAP
	In one month
	In two months
	More than two months
* Please describe any additional details you may have for your office coffee service.