Vender Registration Form | National Federation of the Blind of West Virginia

Name of Vender

Country

Street Address

City

State/Province

Postal Code

Phone Number

Representative’s Name

Primary Products

Payment

Donation Fieldset

Donation Amount

Type your registration fee here

Send a note with your contribution (Please indicate if this donation is in memory of someone, for a particular event, or for dues)

Payment Method

Check this if paying with PayPal.

Check this if sending a check or money order.

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