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  Retailer Request Access  
 
If you would like to become a retailer of CELADON
products, then please fill in the request to be a retailer
form below.


  Contact Name:*  
  Store Name:*  
  Street Address:*  
  Unit/Suite:  
  City:*  
  Province/State:*
  Postal Code/Zip:*  
  Country:*
  Phone:*  
  Fax:  
  E-mail:*  
       
  * required field        
           
 
     
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