Copy of Customer Information Form

Customer Information Form

To request a copy of our Trademark License and Use Agreement, complete the Customer Information Form below and send it to us.

(Your information is being collected so that we may contact you regarding your interest in a Hawaiian Floats Licensing Opportunity. We do not share your information with any outside parties unless you specifically authorize us to do so.)

All Fields * must be completed.

Enter N/A in fields, if "Not Applicable" to your type of business interest.

If requested information is unknown, please enter a brief explanation.

Company Name

First Name

Last Name

Telephone

Email Address

Street Address

City

State

Zip Code

How did you become interested in our Hawaiian Soft-Serve Floats licensing opportunity?

Choose which Restaurant Type below; where you will be using the Hawaiian Floats Trademarks and Menu-Board System:

Fixed Unit (Kiosk Unit, Drive-up Unit, Full Service Cafe Unit, Convienance Store, or other)

Mobile Unit (Concession Trailer or other)

Are you interested in becoming a Licensed Retail Store Dealer with a Fixed Location or a Mobile Unit Dealer ?

Choose which one below best describes your Restaurant Type

You will be adding Hawaiian Soft-Serve Floats to your current menu items.

Hawaiian Soft-Serve Floats will be your main menu item.

Are you interested in adding Hawaiian Soft-Serve Floats to an Existing Retail Store Business?

Choose one:

You are "Now Open" for business.

You will be "Opening Soon" for business.

Please describe your Existing Retail Store Business. Type of business and/or current menu where you would like to add Hawaiian Soft-Serve Floats.

How long has your Existing Retail Store been in business? When did it open and How long have you been the owner?

What is the address, city, state and zip code of your Existing Retail Store Business? The location where you would like to add Hawaiian Soft-Serve Floats. (Our Trademark License Agreement provides a protected territory for our Licensed Retail Store Dealers with fixed locations).

Are you interested in adding Hawaiian Soft-Serve Floats to a New Business that you will soon be opening?

Please describe your New Business type and menu where you would like to add Hawaiian Soft-Serve Floats.

When are you scheduled to open your New Business?

What is the address, city, state and zip code of your New Business location? The location where you would like to add Hawaiian Soft-Serve Floats. (Our Trademark License Agreement provides a protected territory for our Licensed Retail Store Dealers with a fixed location).

Are you interested in opening a new Exclusive Hawaiian Soft-Serve Floats Store

Do you have a location selected where you would like to open a New Exclusive Hawaiian Soft-Serve Floats Retail Store? (Our Trademark License Agreement provides a protected territory for our Licensed Retail Store Dealers with a fixed location).

Please describe your selected location where you would like to open a New Exclusive Hawaiian Soft-Serve Floats Retail Store? (example: Mall Kiosk, Mall In-Line Store, Shopping Strip Center, Other please describe)

What is the address, city, state and zip code of your selected location, where you would like to open a New Exclusive Hawaiian Soft-Serve Floats Retail Store? (Our Trademark License Agreement provides a protected territory for our Licensed Retail Store Dealers with a fixed location).

Are you interested in purchasing one of our Hawaiian Floats Pineapple Float Express Mobile Units?

Will you be operating your Mobile Unit at temporary event locations, such as fairs, festivals, markets and the like? (Temporary Event Locations are events lasting 30 days or less).

Please list Counties and States where you plan to operate your Mobile Unit at Temporary Event Locations.

Will you be operating your Mobile Unit at a Semi-Permanent Location, such as a shopping center parking lot, theme park, recreational park, road-side lot or other? (Please describe Semi-Permanent Location).

What is the address, city, state and zip code of your Semi-Permanent Location where you will be operating your Mobile Unit as a fixed unit?

Have you tasted one of our Hawaiian Soft-Serve Floats? If yes, where did you have one and how was your experience?

Do you have any food service experience? (Please describe)

Are you currently in the food service business? (Please describe)

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