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products?","className":"form-control"},{"values":[{"value":"Baby","label":"Baby"},{"value":"Club","label":"Club"},{"value":"Convenience","label":"Convenience"},{"value":"Drug","label":"Drug"},{"value":"E-Commerce","label":"E-Commerce"},{"value":"Electronics","label":"Electronics"},{"value":"Foodservice","label":"Foodservice"},{"value":"Grocery","label":"Grocery"},{"value":"Home Improvement / Hardware","label":"Home Improvement / Hardware"},{"value":"Mass","label":"Mass"},{"value":"Military","label":"Military"},{"value":"Natural / Specialty","label":"Natural / Specialty"},{"value":"Pet","label":"Pet"},{"value":"Telecom","label":"Telecom"},{"value":"Value / Dollar","label":"Value / Dollar"}],"type":"checkbox-group","name":"channels-of-interest-select-all-that-apply","label":"Channels of Interest (select all that apply):","className":"checkbox-group"},{"values":[{"value":"Headquarter Sales","label":"Headquarter Sales"},{"value":"Order-to-Cash Business Processes","label":"Order-to-Cash 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Shopper Advanced Research"},{"value":"Digital Media","label":"Digital Media"},{"value":"Experiential or Event Marketing","label":"Experiential or Event Marketing"},{"value":"Promotional Merchandise","label":"Promotional Merchandise"},{"value":"Sampling Campaigns","label":"Sampling Campaigns"}],"type":"checkbox-group","name":"shopper-engagement-select-all-that-apply","label":"Shopper Engagement (select all that apply):","className":"checkbox-group"},{"values":[{"value":"Direct to Warehouse","label":"Direct to Warehouse"},{"value":"Distributor Network","label":"Distributor Network"},{"value":"Direct Store Delivery","label":"Direct Store Delivery"}],"type":"checkbox-group","name":"what-is-your-distribution-model-select-all-that-apply","label":"What is your distribution model (select all that apply)?","className":"checkbox-group"},{"values":[{"value":"Yes","label":"Yes"},{"value":"No","label":"No"}],"type":"radio-group","name":"do-you-have-a-current-agency-relationship-for-the-service-for-which-you-are-inquiring","label":"Do you have a current agency relationship for the service for which you are inquiring?","className":"radio-group"},{"values":[{"value":"Yes","label":"Yes"},{"value":"No","label":"No"}],"type":"radio-group","name":"do-you-have-a-relationship-with-acosta","label":"Do you have a relationship with Acosta?","className":"radio-group"},{"type":"text","subtype":"text","name":"if-yes-where","label":"If Yes Where?","className":"form-control"},{"type":"textarea","name":"what-key-information-would-you-like-to-know-about-acosta","label":"What key information would you like to know about Acosta?","className":"form-control"},{"type":"textarea","name":"what-opportunities-are-you-looking-for-acosta-to-assist-you-with","label":"What opportunities are you looking for Acosta to assist you with?","className":"form-control"},{"type":"textarea","name":"what-is-your-timeline-for-representation","label":"What is your timeline for representation?","className":"form-control"},{"type":"textarea","name":"please-provide-any-additional-information-you-would-like-us-to-know","label":"Please provide any additional information you would like us to know.","className":"form-control"}]