Ershig Properties - Mall Specialty Leasing Form

905 N 12th St, Hwy 25E
Middlesboro, KY 40965

HOURS
Mon - Sat: 10am - 9pm
Sun: 12:30pm - 5:30pm

Whether you want to operate for a few a days or a few months, we can provide common
area pushcarts, kiosks, or temporary in-line spaces. Middlesboro Mall provides endless
possibilities for short-term or seasonal leasing. Act now as space is limited. Fill out this
leasing form, which will be emailed to Middlesboro Mall.

* First Name:
* Last Name:
* Company Name:
*Street Address 1:
Street Address 2:
*City:
*State:	*Zip:
*Email Address:
Fax Number:
*Home Phone:
Cell Phone:
* Work Phone:
*Commencement Date:	mm/dd/yyyy
Ending Date (seasonal only):	mm/dd/yyyy
* I am interested in:	Kiosk In-line Leasing

Concept / Product Information

*1. Who is your target customer?
A. Gender	B. Age:	C. Income Level:
Male Female Male/Female
*2. What will be your average price point?
*3. What sales volume would you project for your concept? Monthly sales: Annual sales:
*4. Is your merchandise: Hand-crafted by yourself Wholesaled Franchised
Please Describe:
*5. Do you have established resources/suppliers for the product you will sell? Yes No
* 6. Approximately how long does it take to receive or produce your product? Overnight One Week Two Weeks One Month More than one month
*7. Are you currently operating a business? Yes No If yes: How many locations? How many years have you operated this business?
*8. Have you operated any other businesses: Yes No
9. Have you operated a business in any other mall before?
Location: Dates:	Permanent Temporary Sales:
Location: Dates:	Permanent Temporary Sales:
Location: Dates:	Permanent Temporary Sales:
Leasing Questions:
Proposed Merchandise Concept/theme: (Please describe in detail)

For more information contact:
Charles Burchfield, General Manager
Telephone: 606-248-0397, Fax: 606-248-2422

Email your comments and questions to

Sheila Durham, Marketing Director
Telephone: 606-248-0397, Fax: 606-248-2422

Email your comments and questions to