Venue Information Form
Please complete the following information so we may review your location. Please note that submission of this form does not guarantee approval of hosting a Mystery Box.
Business Location Name
*
Your Full Name
*
First Name
Last Name
Cell Phone Number
*
Format: (000) 000-0000.
E-mail Address (please note that submission of this form allows us to add you to our email list)
*
example@example.com
Relation to the location (Owner, General Manager, etc)
*
Do you have authority to make decisions for this business? If not, who may we contact?
How did you hear about us?
*
Business Location Website
*
Business Location Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If you are located outside our current service areas (regions in CO, KS, MO, FL, TX) would you be interested in self managing the Mystery Box (housing inventory, filling the machine, etc)
*
Please Select
Yes
No
Type of Business
*
Please Select
Bar
Brewery
Dive Bar
Kava Bar
Hotel
Other
Restaurant
Sports Bar
How many locations do you have?
*
Daily Typical Foot Traffic
*
Please Select
Under 50 Customers
50-100 Customers
100-250 Customers
250-500 Customers
500+ Customers
Primary Customer Demographic
*
Please Select
Families
Young Adults / Teens
21+ Only
Mixed
Are you familiar with the adult nature of some of our standard products?
*
Yes
No
Is there an empty space (3ftx3ft) in the business where a vending machine can be installed
*
Yes
No
Please share anything else we should know about your business location for consideration (Please note that submission of this form does not guarantee approval for hosting a Mystery Box):
Submit
Should be Empty: