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Reseller's Application
Legal Business Name:*

You must enter your legal business name.
DBA (if applicable):

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Type of ownership:*

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In business since:*

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Resale License Number: *

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Type of Business:*







Please identify your type of business.
Queen of Stitching User Name*

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Products used for:*

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Shipping Address:*

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Manager's Name:*

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City:*

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Phone Number:*

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State / Province*

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Fax Number:

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Postal or Zip Code:*

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Who can place orders:*

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Country*

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Web Address:

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email address:*

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Submitted by:*

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Projected annual purchases:*

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Title*

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Palace Store