Form to Add Information about a Supermarket

Philosophy

Information

Action

CASPIAN: Consumers Against Supermarket Privacy Invasion and Numbering

Add a Supermarket

Use this form to submit information about a supermarket that is not on the main Supermarket List. I will probably post the information just as you type it here, so try to be accurate with spelling and punctuation. If you would like to add multiple supermarkets, please submit a separate form for each one.

Name of Supermarket:

City: State:
Telephone number (if known):

This market is a:
Chain Single store Don't know

Does the market have a shopper registration ("frequent shopper," "club," "reward," or "loyalty" card) program?
Yes No Don't know

If yes above, does the application require state I.D. or social security number information? (Check "no" if customers who do not want to cash checks have the option of omitting ID and SSN information)
Yes No Don't know

Supermarket website URL (if known)
http://

Additional information or comments:

Your E-mail address [optional]:

I am a privacy advocate. I would only use your e-mail address to contact you about something on this form (e.g., if something got garbled in transit, or if I have a specific question about the supermarket you are submitting). If you want to join CASPIAN please sign up here. Thanks for your input!

CASPIAN
Consumers Against Supermarket Privacy Invasion and Numbering
An information clearinghouse and resource for community and national action

© 1999, 2000 Katherine Albrecht. All rights reserved.