Stix2kooltak - Registration

THIS SECTION is for RETAILERS ONLY Please fill in the Trade Application below and click SEND.
Company/Store name:
GST Registration number:
Owner:
Shipping Address:	(include unit/suite number and PO Box where applicable)
City , Province:	(e.g. Toronto, ON)
Postal Code:
Email Address:
Telephone:
Fax:
Website Address:
Trade References(Provide 2 please)
Name:
Address:	(include unit/suite number and PO Box where applicable)
City , Province:	(e.g. Toronto, ON)
Postal Code:
Telephone:
Name:
Address:	(include unit/suite number and PO Box where applicable)
City , Province:	(e.g. Toronto, ON)
Postal Code:
Telephone:
Comments: