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First Name:
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*
|
|
|
*
|
|
Address 1:
|
*
|
|
Address 2:
|
|
|
City:
|
*
|
|
Country::
|
|
|
State/Province::
|
|
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Zip/Postal Code::
|
*
|
|
Telephone::
|
*
|
|
Comments::
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|
|
Is this a secondary account?:
|
Requested markup?:
|
|
|
Business Name:
|
*
|
|
Business Type:
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*
|
|
e.g. retailer, designer or other (explain)
|
|
Business Title:
|
-
|
|
e.g. Sales Manager
|
|
Tax Id:
|
*
|
|
Business Website:
|
-
|
|
e.g. www.mycompany.com
|
|
Number of Stores:
|
|
|
e.g. 42 or 1,234
|
|
Average Store Size (Square Feet):
|
|
|
e.g. 3,000 or 850
|
|
Are you an authorized buyer?:
|
|
|
Are you an existing Dovetail customer?:
|
|
|
|
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*
|
|
|
*
|
|
|
*
|
|
|
*
|
