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*Type of Account (select one):
A value is required.
*Legal Entity Name
*Ship To Address
Bill To Address (if different than above)
*City, State, Zip
(if different from above)
If you have not already received Pech price book(s) which would you like to have included with your welcome packet?
*Preferred method of shipping
UPS Overnight (monthly charges may apply)
UPS 2nd Day (default)
Crystal Courier (CO only)
ASAP (NE Only)
Method of billing
If buying group, your preferred group:
If you are affiliated with other Pech offices/accounts please list their name(s):
Sales Representative (if known)
Additional Information needed :
To request special services, please contact your Sales Representative
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