Brick & Mortar Preliminary Application
Thank you so much for your interest in Brick and Mortar Link Match. We're excited to learn more about your store and show you how our program can help you. Please answer the following question so that we can better serve you.
Name
*
First Name
Last Name
Job Title
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Store name
Does your store have an FNS number?
*
Yes
No
Are you in the process of getting one now? What is your estimated/anticipated date of starting to accept SNAP/Link in your store
*
What are the average weekly/monthly sales for your store?
*
$
Frequency
Total Sales
Weekly
Monthly
Total Sales
Total Sales (mappable)
On average, what percent of your daily customers use SNAP/Link benefits to purchase?
*
Approximately what percentage of your daily SNAP/Link sales are on produce?
*
This can be a best guess - does not need to be exact.
Do you have fresh fruits and vegetables (not frozen) for sale in your store today?
*
Yes
No
Please describe your produce setup:
*
Upload 2-3 photos of your produce set up
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Tell us your plan to start stocking fresh fruits and vegetables (what do you anticipate stocking, when do you anticipate starting, etc.).
*
Are you able to attend at least one training session per year (it can be virtual depending on proximity to our office)?
*
Yes
No
Do you have access to a computer for submitting weekly reports online?
*
Yes
No
What is your store address?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is the square footage of your store?
*
Submit
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