Catalog Request Page
	Contact Information			Mailing Information
	First Name			Business Name
	Last Name			Address Line 1
	Title	Store Manager Owner President - CEO Buyer Category Manager Clerk Floral Manager Partner		Address Line 2
	Phone	- -  ext.		City
	Fax	- -		State	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY  ZIP/Postal Code
	Email			Country
	Resale Certificate Information			Business Type
	Resale ID No.			Wholesale Floral Retailer-Chain Retailer-Florist
	Issuing State	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY		Designer Manufacturer Other
				Ownership Type
	Catalogs Desired: (Please Check All that Apply)			Sole Proprietorship Partnership Corporation
	Teters
	Spring Cemetery Autumn & Christmas
	Creative Connection by Teters			How did you hear about Teters? Internet Search Retailer Trade Show Print Publication Buying Group Teters Representative Phone Call from Teters Rep Postcard from Teters
	Holiday Spring