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"*" indicates required fields

FIRST NAME*

LAST NAME*

PHONE*

COMPANY*

ADDRESS*

CITY*

STATE*

ZIP CODE

Email Address*

Username*

Password*

Enter Password Confirm Password

TAX ID*

UPLOAD PRESALE PERMIT CERTIFICATE*

Max. file size: 1 GB.

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La Chic Designs

2213 Royal Lane, Dallas, TX 75229
(469)-248-3513
sales@lachicdesigns.com

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