PRESTIGE ALLIANCE MPC

STORE VISIT FORM

DATE & TIME VISITED : _____________________________________

CLIENT ASSIGNED : _____________________________________
STORE / LOCATION : _____________________________________
NAME OF MEMBER/S : _____________________________________
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OVERALL COMMENTS / REMARKS:

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STORE VISIT CONDUCTED BY:

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PRESTIGE ALLIANCE REPRESENTATIVE

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MEMBER’S NAME and SIGNATURE / DATE

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STORE HEAD NAME and SIGNATURE / DATE