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WORLDWIDE'S PROSPECTIVE MEMBER PROFILE
Interested in learning more about Worldwide? Simply complete the profile below and Judy Cyphers, Director of Member Relations, will contact you. All information will be kept strictly confidential.
You must fill in all highlighted fields before submitting form. Incomplete forms will not be sent or saved.
Your Store Name: 
Who should we contact? 
Address 1: 
Address 2: 
City: 
State/Province:        [ 2 Letter ]
Zip Code: 
Phone: 
Fax: 
E-mail Address: 
Do you have a website?:        [ Please enter website's URL or NA if you do not have a website ]
 We are currently a member of a Buying Group.
 We are NOT currently a member of a Buying Group.
Retail Volume:        [ Please enter numbers only. Do NOT enter characters $ , .]
Years in Business: 
Number of Retail Locations: 
Referred By: 
Nature of Retail Business       [ Please select from the list below ]
 Camping/Outdoors  Hunting/Shooting  Fishing/Marine  Hardware/Pet Supplies
 Footwear  Men's Clothing  Women's Clothing  Children's Clothing
 Toys/Seasonal  Lawn/Garden/Paio  HomeWorld
 Athletic Equipment  Hunting/Tactical Apparel
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2016 Worldwide Distributors PO Box 88607 Seattle, WA 98138 (253)872-8746 Fax (253)872-7603