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Purchasing Request

Contact info

(Whom do we call if we have a question about this order?)
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(Use one Request Form per account number.)

ITEM(S):

(Be sure to specify ITEM DESCRIPTION and UNITS for each item. Select ADD+ to include additional items.
(Please provide details here, such as size, shape, color.)
(Please specify, ex. 1 box of 200, 1 ream, etc.)
(Not required, but helpful in knowing specifically what you want.)
(Are you willing to receive a different brand than the one specified?)

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