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      Company Name: 
      
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        Your full company name here  | 
    
    
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      Street Address: 
      
       (No PO Boxes!)  | 
      
         
          
        
        Your complete street address here  | 
    
    
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      City: 
      
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      State: 
      
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        Your state or province  | 
    
    
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      Zip: 
      
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      Country: 
      
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      Website: 
      
         | 
      
         
          
        
        Enter Company Website Here  | 
    
    
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      Contact Person's Name: 
      
         | 
      
         
          
        
        Person for retailers to contact  | 
    
    
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      Contact Person's Email: 
      
         | 
      
         
          
        
        Email address for retailers to use  | 
    
    
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      Contact Person's Phone: 
      
         | 
      
         
          
        
        Phone number for retailers to use  | 
    
    
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      Contact Person's Fax: 
      
         | 
      
         
          
        
        Fax number for retailers to use  | 
    
    
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      Shipping Methods: 
      
         | 
      
         
          
        
        Your shipping methods (UPS, FedEx, etc.) here  | 
    
    
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      Shipping Regions: 
      
         | 
      
         
          
        
        Shipping available to (US only, Worldwide, etc)  | 
    
    
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      Drop Ship (Handling) Fee: 
      
       (if applicable)  | 
      
         
          
        
        Drop Ship Fee/Handling Fee per order (enter NONE for $0.00)  | 
    
    
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      Payment Terms Accepted: 
      
         | 
      
         
          
        
        Payment accepted (Visa, MasterCard, AmEx, Discover, Net 30, etc.)  | 
    
    
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      Ordering Methods: 
      
         | 
      
         
          
        
        How you accept orders (Online, Email, Phone, Fax, etc.)  | 
    
    
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      Comments: 
      
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        Any comments relevant to your business
         
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