Organization:
Your Name:
Your Email Address:
Organization Name:
Organization Type:
Daytime Phone:
Fax:
Address:
Suite or Office No:
City:
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Country:	-- Select -- Antigua Argentina Australia Austria Barbados Belgium Bermuda Brazil Canada Chile China Colombia Croatia Cyprus Czech Repulic Denmark Dominican Republic Finland France Germany Greece Hong Kong Hungary Iceland India Indonesia Ireland Israel Italy Japan Malaysia Malta Mexico Netherlands New Zealand Norway Pakistan Peru Philippines Poland Portugal Russia Saudi Arabia Singapore Slovenia South Africa South Korea Spain Sweden Switzerland Taiwan Thailand Turkey United Arab Emirates United Kingdom United States Venezuela Other
Web address:

Additional Information:
Aprox. Number of people selling: (Select One):
Financial Goal:
Fundraiser Start Date:
Requested Delivery Date:
How did you hear about Kringle?	-- Select -- Advertisment Internet Search Engine Word of Mouth Newspaper/Magazine Ad Other
Please tell us briefly how you plan to promote and sell the Lehmann's Kringle:
How many Kringles do you project to sell ?
Samples Needed?	YES NO