Census Cost Quote Form
Gasoline Station Census Surveys
Customer Information:
Name:
Company Name:
Type of Company:
Phone:
Email:
Census Request Detail:
Markets - Cities, Counties, MSAs, States, Custom Region, and/or Other (please specify):
Time Frame - Please specify year(s) - Current or Most Recent, and/or History:
Station Types - All Stations and Brands in Market, Specific Stations or Brands in Market, C-Stores, Car Washes, Gas Only, Service Bays, Truck Stops, Card Locks, and/or Other (please specify):
Level of Detail - Market Share, Throughput, Class-of-Trade, Fueling Positions, Pump Types, Ancillary Sales/Profit Centers, Co-Branded Fast Food, Facility Features and Services, Address/Phone, Geocoding, or Full Market Detail (please specify):
Preferred File Format - Excel, FoxPro, CSV, Tab-Delimeted Text, or other (please specify):
Delivery - Email, FTP, Disk, CD, Hard Copy, Mail, FedEx, or Other (please specify):
Comments:
Tel:(805)383-2400  Email:lsi@lundbergsurvey.com  Fax:(805)383-2424