Buyer Registration

Please provide copies of the following:

• Business Cards
• Business Tax I.D.
• Personal I.D. (Driver's License, Passport, etc.)

* Denotes required fields

*Show Selection
	February 13 – 15, 2012
	August 2012 - TBA
Contact Information
*Buyer Name
*Business Name
*Mailing Address
*City
State	--- SELECT STATE ---ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIARHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMINGAMERICAN SAMOAFEDERATED STATES OF MICRONESIAGUAMMARSHALL ISLANDSNORTHERN MARIANA ISLANDSPALAUPUERTO RICOVIRGIN ISLANDSArmed Forces Middle EastArmed Forces AmericasArmed Forces Pacific
*Zip
*Country
Province
*Telephone
Fax
*E-mail
Website
Business Documentation
*Tax Permit #
*Title	--- SELECT ONE ---CEOPresidentGMMMerchandise ManagerAssistant BuyerOwnerVice PresidentDMMBuyerStore Manager
*Type of Business	--- SELECT ONE ---Independent SpecialtyStore Buying OfficeExporter/ImporterE-BusinessSpecialty Store ChainSalon/SpaDistributor/WholesalerDepartment StoreCatalog/Mail CenterConcessions/Outlet/BazaarMass Merchant/Discount StoreTrading Company
*Number of Stores You Buy For	--- SELECT ONE ---12 - 56 - 20More than 20
*Classify Merchandise	-- SELECT CLASSIFICATION --BudgetModerateBetterBridgeDesigner
*I Buy Merchandise For (check all that apply)	Kids Pre-teen Junior Missy Menswear Contemporary Plus Size
*I Am a Buyer For: (check all that apply)	Swimwear Beachwear Accessories Resortwear Sportswear Active Apparel
6-digit code below:  (This helps reduce spam)

Submit this application in order to receive your badge in advance. Admission on to the show floor is for qualified retailers/buyers only. Upon arrival, pre-registered buyers will be asked to present their badge and a photo I.D. in order to pick up their badge holder.

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