Calling all store owners

Would you like to have a large format LCD screen in your store window?

If you have received a communication from us directing you to log on to this site, please complete the form below and click the 'Submit' button at the bottom of this page.

Thank you for your continued interest in Street Media

About your store

Company Name

Fascia

Address Line 1

Address Line 2 optional

Address Line 3 optional

Town optional

County optional

Postcode

Address No address selected.
Adjust

Proprietor Telephone

Is there a Post Office on site Yes No

Branch No./FAD

Trade Type Independent Multiple

Do you belong to a buying group? ------ Select one ------ NO ALEEF NEWS APPLEBY WESTWARD ARAMARK LTD BLAKEMORE C J LANG CAPPER CENTRA COSTCUTTER FINLAYS NEWSAGENTS G101 OFFSALES JAMES HALL JOHN HENDERSON JOURNEYS FRIEND LANDMARK LONDIS MACE MSR GROUP NISA PALMER & HARVEY PREMIER SUPERSHOP SUPERVALU VG YOUR STORE OTHER

Trade Sector Chemist Convenience CTN Forecourt Grocer Kiosk Leisure Motorway Off License Other Post Office Public House Variety

If you own any other stores that trade with us
please provide an outlet ID for one of these stores

Proprieter First Name

Proprieter Second Name

Contact First Name

Contact Second Name

Floorsize (sq ft)

Number of customer transactions per week

Turnover (£/Week)

Fuel sales (£/Week) optional

Opening Hours Monday - Friday Saturday Sunday Open -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 Close -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 -- select one -- 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00

Paypoint (£/Week)

Parking - No. of spaces 0 1 - 5 6 - 10 11 - 15 16 - 20 20+

Staff numbers

Freehold or Leasehold Freehold Leasehold

Landlord if leased

What other services do you provide?
i.e. ATM, Newspaper delivery
optional

The data collected via this form will be used by Street Media Networks Ltd for the sole purpose of administering retailer selection process.

Street Media Networks Ltd Registered Office: 145 St John Street, London, EC1V 4PY
Registered in England and Wales No. 07698940