CAMPAILLOU (11065)

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Who can we contact to confirm orders ?

Name*

First Last

Email*

Phone

Where should we SHIP ? (You can always update the delivery address for each order)

Bakery / Restaurant / Business Name

Delivery Address

Street Address Address Line 2 City State ZIP Code

Deliveries currently available in the following states :

Who can we contact regarding deliveries ?

Same contact person as above

Use the same contact information as above

Delivery Contact Person Name

First Last

Delivery Contact Person Phone

What information should be used on invoices?

Same as delivery information

Use the delivery address information

Bakery / Restaurant / Business Name

Address

Street Address Address Line 2 City State ZIP Code

T65 (29900)

T45 GRUAU ROUGE (00982)

T80 MEULE (46503)

VIOLETTE T45 (61895)

CAMPAILLOU (11065)

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Phone

This field is for validation purposes and should be left unchanged.