Pizzeria Nomination Form

We are building an international network of pizza restaurants that deliver, so that computer users everywhere will be able to order pizza right from their computer via the Internet. Please use this form to nominate your favorite pizzerias. We'll contact the restaurants you recommend, and invite them to participate in our program.

Perhaps you would even consider joining our
Pizzeria Recruiter Team
and GET PAID for helping us grow!

If your browser does not support forms you may obtain a Nomination Form from our document request area.

Your Name:
Email Address:
Restaurant/Pizzeria Name:
Address:
City:
State or Province: ZIP+4 / Postal Code:
Country:
Owner's Name (if known):
Manager's Name (if known):
Phone Number: Area Code: () Phone Number:
Fax Number: Area Code: () Fax Number:

We invite your complimentary comments about the pizzeria you are nominating. (We would like to quote you when we contact the pizzeria, so please say something nice.):

Please tell us anything else you know about the pizzeria you are nominating:

If this pizzeria becomes a participating member of our pizzeria network, would you like to enjoy the convenience of ordering food through the Internet?
Yes: No:

Are you known here by name, and if so, may we mention your name as the person who referred us to this pizzeria?
Yes: No:

When finished click on the Submit Nomination button. Only press Reset if you want to start completely over.

Thanks For Your Help!

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