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Your Name:
Store Name:
Phone Number:
E-mail:
Number Attending Day 1:
Number Attending Day 2:
Have you attended previous VBG show events?
Yes
No
If Yes, how many previous shows have you attended?
1 - 3
4 - 6
7 - 10
10 or more
Are you involved in Video Game Rentals?
Yes
No
Are you involved in the Indoor Tanning Industry?
Yes
No