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Current China Mist® Brands Distributors
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Food Service Form

To request information please complete the following form.
Check each box that applies to your business.

Contact Information:

Name:  
Position:    If "Other", please list:
Company:
Address:
City:
State:
Country:
Postal Code:
Email Address:
Website:
Contact Phone:  Extension:
Cell Phone:
Fax:
Business Type:
Coffee & Tea Shop Gourmet Store
Department Store Specialty Market
Supermarket Mass Merchandiser
Catalog Specialty Gourmet Distributor
Broker Other: please list:
       
Delivery System:
Truck Routes Mail Order
Catalog Sales Internet Sales
None Established Other: please list:
       
Heard About Us:   If Other, please list:
Market Area:
Product Interest:
China Mist® Iced Tea
China Mist® Pure Bottled Organic Tea
Leaves Pure Teas® Hot Teas
Mokarabia® Real Italian Coffee and Espresso
All China Mist® Brands
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