Name of Shop*Shop Owner(s)*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone NumberYears in OperationType of Shop*General RepairUndercar SpecialistImport SpecialistUnderhood SpecialistMobile ShopCollisionElectricalTire DealerNumber of LocationsNumber of BaysShop Website Are you affiliated with any program group? (NAPA, Federated, etc…)*YesNoList AffiliationsASE Blue Seal Shop?*YesNoWeekly Car CountNumber of EmployeesNumber of TechniciansNumber of Front Counter StaffNumber of Other EmployeesASE Certifications*Master TechnicianA1A2A3A4A5A6A7A8X1C1F1G1L1L2P2T1T2T3T4T5T6T7T8Other CertificationsPlease describe in 75 to 100 words what characteristics separate your shop from your local competitors: Example – ASE certified techs, special promotions, support Car Care programs, active in local community, attractive waiting room and other customer oriented services: Who do you buy the majority of your filters from?*NameThis field is for validation purposes and should be left unchanged.