Caffeine and
Caffeine Free
Products
Promotional Material Request Form
Coke
Name
of Coke
Business:______________________________________________________________
Diet
Coke Zero
Name of Owner:________________________________________________________________
Barq’s Root Beer
Dr. Pepper
Person
authorized to order:________________________________________________________
Vitamin Water Energy/Tropical Citrus
Telephone Contact: WK/HM______________________ Mobile________________________
CAFFEINE
Email Address:_________________________________________________________________
CAFFEINE FREE
Please give exact and clear directions to your place of business. Please use another form for other
locations if necessary.
Goombay Fruit Champagne
Sprite
1. Do Zero
you have an account with us? If yes please
print Dry
the Name
on Ale
the line below:
Canada
Ginger
Sprite
Vitamin Water Essential/Orange Carrot
Fanta
Orange
2. _________________________________________________________________
Vitamin Water Focus/Kiwi Strawberry
Fanta
Grape
3. What
is the nature of business? ________________________________________
Vitamin Water Power-C/Dragon Fruit
Fanta
Strawberry
4. Where do you purchase product? _____________________________________
Water
Revive/Fruit Punch
Fanta
Fruit
Punch
5. What
types
of product do you purchase? Vitamin
Please identify
below
Vitamin Water XXX/Acai Pomegranate Blueberry
Fanta Red Cream
 Sodas:
________
Vitamin Water Zero Rise/Orange
Barritt’s Ginger
 Juice:
________
All V8 Fusion
Schweppes Tonic
 Water:
All V8 Splash
Schweppes
Club Soda_________

Vitamin
Water:
_________
Schweppes Ginger Ale
All Minute Maid juices
 Frozen
Cocktail: _________
All Powerade drinks
Goombay
Punch
Please specify requested Coca-Cola material below. Please print.
Caffeine
and Caffeine Free
www.cbcbahamas.com