WIC UPC Database SurveyWIC UPC Database Survey

*

1. Select Your Store Name:

Select Your Store Name:

Note: If you are filling out this survey for corporate
           stores and want to have all survey answers
           apply to all of your stores/locations, please select
           one corporate store name and do not select a WIC
           ID number below. When the data is compiled, all of
           the survey answers will be applied to all of
           your stores.

2. Select Your 4 Digit WIC ID Number:

Select Your 4 Digit WIC ID Number:

*

3. Please indicate below how soon you will be able to incorporate and use the Ohio WIC UPC database into your current retailer system:

Please indicate below how soon you will be able to incorporate and use the Ohio WIC UPC database into your current retailer system: Already using

Within 3 months

Within 6 months

Within 1 year

Within 2 years

Longer than 2 years

Never (I am a vendor without an Electronic Cash Register system)

*

4. Once the UPC database is implemented in your store(s), will you have the capability to provide WIC sales data on a regular basis?

Once the UPC database is implemented in your store(s), will you have the capability to provide WIC sales data on a regular basis? Yes

No

*

5. Please provide the contact information for the staff that is able to provide WIC sales data for your store:

Please provide the contact information for the staff that is able to provide WIC sales data for your store: Name
Telephone Number
Email Address

6. Comments:

Comments:

*

7. Name/Title of person completing this survey:

Name/Title of person completing this survey: Name
Title