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Payment Preferences

Company Check
Bank Check
Cashier Check / Money Order
Credit Card (Visa / Master)
Cash
Credit Terms (references maybe required)

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How did you hear about us?

Referral (please specify in others)
Yellow Page
TV / Magazine Ad
Search engine
Blue book
Social media
Alibaba
Bid clerk
Trade show

Information collected, including name, phone number, email address and postal address, will only be used for the
purpose of processing business or general inquiries related to JK Kitchen and Bath Orlando, and will be treated in
confidence and not be disclosed to any other party. If you wish to access or correct your personal data, please send
e-mail to Communications Manager at [email protected]

By checking the "I Agree" button below, I verify that I have reviewed the Dealer Requirements and I understand and
agree to the commitments shown thereof. I also verify that the above information provided is accurate.

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