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Shelf Tag and Supply Request Form
Please fill out and submit this form.
3
Questions
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1
Please provide your Pine State Spirits Account Number and Store Name
*
This field is required.
Pine State Spirits Account Number
Store Name
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2
Please check what you are requesting
*
This field is required.
Pine State Shelf Tags
Backers for Shelf Tags
Monthly Special Tag Clips
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3
Pine State Shelf Tags
*
This field is required.
Please list the item number(s) of the product(s) you wish to receive tag(s) for
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4
Backers for Shelf Tags
*
This field is required.
How many bricks would you like? (250 backers per brick)
Please Select
1 (250 total)
2 (500 total)
3 (750 total)
Please Select
Please Select
1 (250 total)
2 (500 total)
3 (750 total)
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5
Monthly Special Tag Clips
*
This field is required.
How many bags would you like? (50 clips per bag)
Please Select
1 (50 total)
2 (100 total)
3 (150 total)
Please Select
Please Select
1 (50 total)
2 (100 total)
3 (150 total)
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6
Your Email
example@example.com
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