Regional Access New Supplier Survey Your Company Name(Required)Use your brand name if you feel its more applicable! Your Name(Required) Your Title(Required) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail(Required) Website and/or Social Media presence(Required) What is the origin story of your business(Required)Be as succinct or as long-winded as you like. What type of product do you want Regional Access to distribute for you?(Required)Grass-fed yogurt? Bulk nut butters? Let us know what type of products you sell. What attributes separate / distinguish your products from the competition?(Required) Product Class(Required)Please check all that apply. Beverages Bulk Foods Cheese Dairy and Refrigerated Dry Grocery Fresh Produce Frozen Meat Other Other Product ClassPlease describe your product class Which of these two markets do you think your product is BEST suited for? Retail Restaurants and Institutions Who do you see as target customers for your product?(Required)Please check all that apply. Bakery College/Institutional Food Service Manufacturer Restaurant Retail Chain Retail Coop Retail Independent Other Other target customersYou have selected other, please describe Is your product currently being sold at retail?(Required) Yes No How many Retail Locations are you in currently? 0 1-10 10-20 > 20 What regions can people find your product in?(Required) Nationally Northeast New England New York Locally Other Are you currently working with a distributor(s)?(Required) Yes No How do you feel about working with your existing distributors?(Required) * ** *** **** ***** Which distributors are you currently working with?(Required)Help us understand your current place in the market! What volume are you selling with your current distributors?(Required)Use whatever volume makes sense for the product; cases, pounds, units, etc. Do you have any geographic exclusivity agreements with existing distributors?(Required) Yes No Other How does your product(s) need to be stored?(Required) Dry Frozen Refrigerated Other Do your products currently have UPC's?(Required) Yes No How much margin have you built in between what you will sell a product to Regional Access for (Our Cost) and what the end consumer would pay (MSRP)?(Required)Calculate margin: (MSRP - Our Cost)/MSRP 20-40% 40-60% 60-80% 80% or more Pricing Upload(Required)Max. file size: 50 MB.Please submit pricing for your products. Please include any shipping charges and suggested MSRP for each item.How will we get the product?(Required) Delivery Pickup Both Where is the pickup Location?(Required) Street Address Address Line 2 City ALAKAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPAPRRISCSDTNTXUTVTVAWAWVWIWY State Zip Code What is the order minimum?(Required) What is the order lead time?(Required)How much time do you need to get a distributors purchase order ready? Do you have direct customers you want Regional Access to take over distribution to?(Required)Are you currently handling your own distribution for any accounts? Yes No Other Do you have existing or potential customers ready to write POs to Regional Access?(Required) Yes No Other What type of opening deal are you able to offer to new placements?(Required)Often customers will ask for incentives to carry a product for the first time. Do you currently offer promotional allowances?(Required)A promotional allowance might be an off-invoice discount, point of sale materials, demo budgets, and so on. Yes No Other How frequently are you able to offer promotional allowances?(Required) Monthly Seasonal Yearly Other Do you have sample packs available?(Required)When providing samples, your product must be packed appropriately and clearly labeled. We will work with you on sales inserts, sample sizes and quantities. Yes No Do you have sales representatives or brokers willing to help our sales team with product placement?(Required)It can be hard to keep up! We understand many producers may not have a dedicated internal sales team. Yes No Other Are you able to visit stores or do in-store demos?(Required) Yes No Other Are you able to provide passive in-store demo kits?(Required)If appropriate for the product, an in store demo kit might include product, displays, and coupons. Yes No Other What would make a successful relationship with Regional Access from your perspective?We want to be a great partner for you. Please help us understand your goals!It's important that Regional Access move a high volume of my product.(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree It's important that Regional Access place consistent orders.(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree I'm hoping Regional Access can help me scale(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree I feel like I understand the differences between direct, wholesale, and distributor pricing.(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree If there was a lot of demand, I'm confident I could scale my production to meet it.(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree I hope to be, or already am, a nationally recognized brand.(Required) Strongly Agree Agree Neutral Disagree Strongly Disagree What else would you like us to know?Is there anything not covered in this survey you would like us to know when we assess your product?CAPTCHAUntitled FileMax. file size: 50 MB.FileMax. file size: 50 MB.
