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