Organization Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Selling Methods *

Local (No Online Sales)

Online Only

Hybrid of Local & Online

Local - only physical brochure and order forms will be used. Customer orders are sorted and all orders include free shipping. Organization Share is 40%

Online Only - all orders are collected online via a portal. Flat rate shipping; direct to customer. Organization Share is 50%

Hybrid - Local & Online only orders are collected. Organization share is 45%

Preferred Start Date (allow 4 weeks from today's date) *

MM

DD

YYYY

Preferred End Date (Recommend 2-3 weeks from Start Date) *

MM

DD

YYYY