• First Name*
• Last Name*
• Company Name*
• Street Address*
• Street Address 2
• City*
• State*
  -- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
• ZIP*
• Email Address*
• Fax
• Home Phone*
• Cell Phone*
• Work Phone*
• Commencement Date*
• End Date
• I am interested in:*
  • RMU
  • Kiosk
  • In-line Space

• Who is your target customer?

• Gender*
  • Male
  • Female
  • Male/Female
• Age*
  -- Select --Under 1818-2425-3435-4445-54Over 55
• Income Level*
  -- Select --Under $15,000$15,000-$24,999$25,000-$34,999$35,000-$49,999$50,000-$74,999$75,000-$99,999$100,000 or more

• Product / Concept Information

• What will be your average price point?*
• What sales volume would you project for your concept?
• Monthly Sales*
• Annual Sales*
• Is your merchandise:*
  • Hand-crafted by yourself
  • Wholesaled
  • Franchised
• Please describe in detail your concept & merchandise:
• Do you have established resources / suppliers for the product you will sell?*
  • Yes
  • No
• How long does it take to receive or produce your product?*
• Attach image of product or RMU

• Are you currently operating a business?

• Are you currently operating a business?*
  • Yes
  • No
• How many locations?
• How many years have you operated this business?
• Have you operated any other businesses:*
  • Yes
  • No
• Have you operated a business in any other mall before?
• Location
• Dates
• Type
  • Permanent
  • Temporary
• Sales
• Location
• Dates
• Type
  • Permanent
  • Temporary
• Sales
• Location
• Dates
• Type
  • Permanent
  • Temporary
• Sales

• Leasing Questions

• Proposed Merchandise Concept/theme
  Please describe in detail
• Would you like a product image mailed to you?*
  • Yes
  • No
• Comments
  This field is for validation purposes and should be left unchanged.