To start your free subscription to C/Stores On Campus , please fill out the subscription form below completely. (If we have any questions, we'll contact you.)

(*)Indicates a required field:

*I wish to receive a free subscription to C/Stores On Campus.
Yes No

*First Name: 
*Last Name: 
*Title: 
*School: 
*Store Name: 
*Address: 
*City:   *State:  [ choose one ] AA AE AK AL AP AR AZ CA CO CT DC DE FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY ZZ

(For foreign addresses enter ZZ in state and zip code fields, and input country in country field.)

*Zip Code: 
Country: 
Province: 
Foreign Zip: 
*Phone: 
Fax: 
*Email: 

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Please provide the following information about yourself, your school and its convenience store operations:

(A) Describe your relationship to the campus convenience store(s):
I manage/operate a convenience store on a college or university campus.
Someone who works for me manages/operates a convenience store on a
     college or university campus.
I buy or decide the product assortment for the campus convenience store.
None of the above. My relationship is  



(B) School enrollment: 

Type of school:
Residence
Commuter
Both



(C) Number of convenience stores on campus: 

  Do you use campus cards?    Yes No

(D) Total annual convenience store sales volume. $ 



(E) Who oversees the convenience store(s)?:
Food Service
Bookstore
Other



(F) Type of operation:
Institution-operated
Leased
    If leased, company name of lease operator: 



(G) Is your store a member of:

  NACUFS?   Yes No

  ACAP?   Yes No

  NACAS?   Yes No

  Nat'l Assn. of Convenience Stores?   Yes No

  Nat'l Assn. of College Stores?   Yes No

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List below the names and titles of anyone at your facility you want to receive a FREE subscription to C/Stores On Campus. (We're sorry–but names without titles cannot be processed.)

First Name: 
Last Name: 
Title: 



First Name: 
Last Name: 
Title: 



First Name: 
Last Name: 
Title: 

If you have any questions, please call the Circulation Department
at 516-334-3030

or email us at
ebmcirc@ebmpubs4.com